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Biomedical subjects

D H Friedlander

Publications and source records attributed to D H Friedlander.

9 recordsLinked to original sources
PubMed1991

Cholesterol atheroembolism: an increasingly frequent complication of cardiac catheterisation.

Cholesterol atheroembolisation is increasingly encountered as a complication of cardiac catheterisation. We report three cases seen recently in our unit. Autopsy and histological evidence confirmed cholesterol atheroembolism in one case, while the other two patients presented with classical clinical features of this condition. All three patients were elderly with extensive atheromatous disease. No excessive difficulty was encountered at catheterisation. Embolisation involved the gastrointestinal tract, the skin and extremities, and the kidneys. Despite anticoagulation, dialysis and surgical intervention all our patients died. With investigative and therapeutic catheterisation being increasingly performed in the setting of severe atherosclerosis, the need for continued scrutiny for catheter-induced complications is emphasised.

Age Factors↗
PubMed1991

Early management of myocardial infraction: a report from the Waikato Hospital, New Zealand.

A retrospective review was made of the early management of 50 consecutive patients admitted with an acute myocardial infarction to assess the potential suitability and actual application of thrombolysis, intravenous beta-blockade and aspirin therapy. Thrombolysis was indicated for 15 patients (30%), of whom 14 actually did receive intravenous streptokinase. Thus, 93.3% of all eligible patients received thrombolysis. The main contraindication to thrombolysis was a presentation more than six hours from onset of symptoms in 26 patients (52%). Intravenous beta-blockade was indicated for 17 patients (34%), six patients were actually treated resulting in a therapeutic coverage of 35.3%. Heart failure in 21 patients (42%) was the main contraindication. Aspirin was indicated for 48 patients (96%). However, only 14 were treated giving a therapeutic coverage of 29.2%. A large majority of our patients with an acute myocardial infarction were eligible to receive aspirin which has been a neglected therapeutic modality.

Administration, Oral↗
PubMed1979

Captopril and propranolol in mild and moderate essential hypertension: preliminary report.

A randomised open trial was carried out to test the efficacy and safety of Captopril and propranolol in 20 patients with mild and moderate essential hypertension. Mild and moderate was defined as a resting supine diastolic pressure of 100 to 120mmHg at the end of a placebo period. Patients were then randomised into Captopril (12) or propranolol (8) group. After a four-week dose ranging period, they were maintained on the treatment drug, or, if still uncontrolled, the other drug was added. The patients showed good overall blood pressure response to both treatment regimes. Three patients in the Captopril group developed a rash. The significance of the effectiveness in essential hypertension of a drug which acts to block the renin-angiotensin-aldosterone system is discussed.

Adolescent↗
PubMed1975

Acute coronary artery disease and oral contraceptives.

The Waikato Hospital experience of women admitted or seen in the Cardiology Outpatient Clinic who were under the age of 40 and whose diagnosis was a recent acute coronary occlusive episode was reviewed. It was found that there were nine admissions in eight women in this category between December 1971 and November 1973, plus one further patient who was seen with a recent acute ischaemic episode as an outpatient. The histories of these patients were reviewed and their risk factors surveyed. Of the nine women in the study, seven were taking oral contraceptives. As opposed to previous studies, not all the women in this study showed risk factors other than oral contraceptive usage. Three patients in this group taking oral contraceptives and who were thought to have definite coronary ischaemic episodes had no other major risk factor though two of the three were obese. It is thought probable that oral contraceptives containing oestrogens should be considered as a coronary risk factor in young women.

Acute Disease↗
PubMedDate not supplied

Idiopathic infantile arterial calcification with survival to adult life.

Moran, in an excellent review, defined idiopathic infantile arterial calcification as a rare disorder of undetermined etiology, characterized by deposition of calcific material along the internal elastic membrane of large, medium, and small arteries. Fibrous proliferation in the intima occurs and the arterial lumen is narrowed. The constellation of affected tissues varies but the coronary arteries are almost always involved whereas the arteries of the central nervous system are spared. Death from myocardial infarction usually results within the first six months of life. To date there have been only three survivors. We present the case history of a fourth survivor, a 22-year-old woman who, at the age of three months, was diagnosed as having idiopathic infantile arterial calcification.

Adolescent↗