PubMed Health⌕ Search

Biomedical subjects

D Cragg

Publications and source records attributed to D Cragg.

5 recordsLinked to original sources
PubMed1995

Comparison of outcome in patients with acute myocardial infarction aged > 75 years with that in younger patients.

Despite the advancements in reperfusion therapy, elderly patients with acute myocardial infarction (AMI) continue to have higher mortality and complication rates than younger patients. To evaluate this group we reviewed 994 consecutive patients with AMI at our hospital during a 24-month period. There were 307 patients aged > 75 years and 687 younger patients. Demographic analysis of the 2 groups showed that the elderly had a higher proportion of women (56% vs 31%, p < 0.01), more previous AMI (32% vs 23%, p < 0.01), and a higher incidence of bundle branch block (18% vs 8%, p < 0.01). Only 8% of the elderly and 36% of the younger patients were considered eligible for thrombolysis (p < 0.01). In the elderly, risk of bleeding and late presentation were the most common reasons for exclusion from treatment with thrombolytic therapy. Despite a higher proportion of non-Q-wave AMI (56% vs 44%, p < 0.01) in the elderly, the incidence of congestive heart failure (47% vs 23%, p < 0.001) and death (28% vs 11%, p = 0.001) was greater. Causes of death were not significantly different. Increased mortality in the elderly was not due to multisystem failure but to impaired myocardial reserve, suggesting that more aggressive reperfusion strategies may improve prognosis.

Adult↗
PubMed1994

Organisation of primary care services outside normal working hours.

OBJECTIVE: To determine the use and organisation of out of hours services in primary care. DESIGN: Telephone survey. SETTING: Family health services authorities in England and Wales. MAIN OUTCOME MEASURES: Rate of use of out of hours care, methods of provision, and role of authorities. RESULTS: 12-25% of authorities were unable to answer one or more key questions in the survey because of insufficient information. The mean number of night visits made per unrestricted principal per 1000 patients per year was 35.3. 13 of the 19 authorities with averages above 40 covered large towns or cities. 81 authorities had at least one commercial deputising service. In 46 metropolitan districts and one other district over 75% of general practitioners had consent to use a deputising service, although not all did so. Information on cooperation between practices was limited. 22 cooperatives were recognised by the authorities, nine were not officially recognised, and a further 13 were nearing institution. Only two cooperatives were in areas with extensive use of deputising services. CONCLUSION: Methods of providing out of hours care are changing, and without good information systems family health services authorities will not be able to monitor the effect on quality and cost effectiveness of care.

Contract Services↗
PubMed1990

The List of Threatening Experiences: the reliability and validity of a brief life events questionnaire.

During the 23 years since the original work of Holmes & Rahe, research into stressful life events on human subjects has tended towards the development of longer and more complex inventories. The List of Threatening Experiences (LTE) of Brugha et al., by virtue of its brevity, overcomes difficulties of clinical application. In a study of 50 psychiatric patients and informants, the questionnaire version of the list (LTE-Q) was shown to have high test-retest reliability, and good agreement with informant information. Concurrent validity, based on the criterion of independently rated adversity derived from a semistructured life events interview, making use of the Life Events and Difficulties Scales (LEDS) method developed by Brown & Harris, showed both high specificity and sensitivity. The LTE-Q is particularly recommended for use in psychiatric, psychological and social studies in which other intervening variables such as social support, coping, and cognitive variables are of interest, and resources do not allow for the use of extensive interview measures of stress.

England↗
PubMed1987

Echocardiographic left ventricular mass and function in the hypertensive baboon.

Nonhuman primates with chronic systemic hypertension provide an ideal model for studying structural and functional alterations associated with compensatory cardiac hypertrophy. Since noninvasive techniques are useful for the longitudinal evaluation of these animals, we sought to critically asses the M-mode echocardiographic estimation of left ventricular mass in the baboon and to characterize estimates of left ventricular size and function in baboons with chronic renal hypertension. In 23 baboons (12 normotensive, 11 chronic hypertensive), M-mode echocardiography-determined left ventricular mass was 73 +/- 13 (SE) g as compared with the necropsy weight of 69 +/- 11 g (p = NS), and the correlation was excellent (r = 0.94). When 30 chronically hypertensive baboons being observed longitudinally were compared with 10 normotensive control animals studied under identical conditions, several differences were noted in measures derived from echocardiography and high fidelity pressure measurements. Left ventricular systolic pressure was considerably higher in the hypertensive baboons (113 +/- 23 vs 90 +/- 11 mm Hg; p less than 0.001), as was left ventricular mass (148 +/- 60 vs 103 +/- 38 g; p less than 0.03). However, since the ratio of posterior wall thickness to cavity dimension was larger in the hypertensive baboons (0.52 +/- 0.17 vs 0.43 +/- 0.07; p less than 0.05), this concentric hypertrophy maintained values for left ventricular meridional stress at the same level as in the control animals. Despite matched heart rate and left ventricular stress, the rates of change in left ventricular dimensions and wall thickness in systole and diastole were all approximately 25% less in the hypertrophied baboons.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗