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Biomedical subjects

D Clay

Publications and source records attributed to D Clay.

5 recordsLinked to original sources
PubMed1992

Comparison of fetal cerebellar measurements by two different techniques.

We examined 53 fetuses between 15 and 40 weeks of gestation with transverse and coronal sections of the head in order to evaluate the accuracy and reproducibility of the coronal cerebellar diameter. Intraobserver coefficient of variation was less than or equal to 2.2% and the mean interobserver difference was 2.2% (range, 0 to 6%). A positive linear correlation exists between transverse and coronal measurements (coronal diameter = 1.02 x transverse diameter - 0.48; R2 = 0.99; P less than 0.0001). We conclude that the coronal cerebellar diameter is reproducible and accurate and when indicated clinically can be used instead of the transverse cerebellar diameter when the latter is not obtainable because of fetal position.

Biometry↗
PubMed1988

Tocainide for drug-resistant sustained ventricular tachyarrhythmias.

Eighty-two patients with drug-resistant ventricular tachycardia or fibrillation were treated with oral tocainide. Treatment in 54 patients, all with inducible ventricular tachycardia or fibrillation at baseline electrophysiologic testing, was based on the results of invasive electrophysiologic testing. Twenty-eight additional patients with frequent spontaneous ventricular tachycardia or no inducible arrhythmia during electrophysiologic testing were treated on the basis of the findings of electrocardiographic (ECG) Holter monitoring. Tocainide was effective in 7 (13%) and partially effective in 5 (8%) of the 54 patients in the electrophysiologic study group and was effective in 17 (61%) of the 28 patients in the ECG monitoring group. History of previous myocardial infarction and failure of response to lidocaine correlated with failure to respond to tocainide. Side effects were common both during initial therapy and during long-term treatment and necessitated discontinuation of tocainide therapy in 17% of the patients. At a mean follow-up period of 14 months, 13 patients are still receiving tocainide and are arrhythmia-free. In conclusion, the usefulness of oral tocainide in the management of drug-refractory sustained ventricular tachycardia or fibrillation is limited because of its low effectiveness and frequent side effects.

Anti-Arrhythmia Agents↗
PubMed1986

Determinants of prognosis in ventricular tachyarrhythmia patients without induced sustained arrhythmias.

We studied 59 patients with sustained ventricular tachycardia (VT) or ventricular fibrillation in whom programmed stimulation induced 15 or fewer repetitive ventricular complexes. During follow-up of 2.2 +/- 1.5 years, 13 patients had an arrhythmia recurrence and seven died suddenly. At 1, 2, and 3 years, the actuarial incidence of arrhythmia recurrence was 15 +/- 5%, 17 +/- 5%, and 23 +/- 6%, and that of sudden death was 6 +/- 4%, 15 +/- 6%, and 21 +/- 8%. Prior myocardial infarction (MI) was the only independent predictor of arrhythmia recurrence (p less than 0.02) and sudden death (p = 0.05): at 2 years, 36 +/- 12% of 18 patients with MI and 8 +/- 4% of 41 patients without MI had arrhythmia recurrence, and 24 +/- 12% with MI and 3 +/- 3% without MI died suddenly. None of the nine patients with greater than or equal to 70% coronary stenosis but no MI had arrhythmia recurrence after anti-ischemic therapy. Possible arrhythmia-precipitating conditions were present during all arrhythmias in 14 patients, but did not predict freedom from arrhythmia recurrence (p = 0.52) or sudden death (p = 0.81). The maximum number of induced ventricular complexes did not predict arrhythmia recurrence or sudden death: for patients with 0 to 2, 3 to 5, and 6 to 15 induced complexes, the 2-year incidence of arrhythmia recurrence was 16 +/- 7%, 15 +/- 10%, and 18 +/- 10%; for sudden death, it was 9 +/- 6%, 0 +/- 0%, and 14 +/- 9%. In this group of patients, prior MI predicted arrhythmia recurrence and sudden death.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗