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Biomedical subjects

G C Sutton

Publications and source records attributed to G C Sutton.

At least 19 recordsLinked to original sources
PubMed1995

Complete heart block and severe tricuspid regurgitation after radiotherapy. Case report and review of the literature.

Cardiac complications can occur long after chest radiotherapy. We describe a patient who developed both valve disease and complete heart block at different intervals following radiotherapy for Hodgkin's disease. The combined presentation of these two very rare cardiac complications and surgery for radiation-induced tricuspid valve disease have not been described before.

Adult↗
PubMed1992

Predictors of prognosis in severe chronic heart failure.

A total of 127 patients with chronic heart failure referred to our exercise laboratory were studied retrospectively to identify parameters predictive of prognosis. Patients were followed for a mean of 14.6 months. The group as a whole had severe ventricular dysfunction with a median ejection fraction of 17% and a median peak rate of oxygen consumption of 13.7 ml/kg/min. During the follow-up period 23 patients (18%) died and 18 (14%) underwent cardiac transplantation. The effect of the following variables on outcome (death or transplantation) were examined: age, cause of heart failure, cardiothoracic ratio on chest radiography, left ventricular end-systolic dimension on echocardiography, left ventricular ejection fraction on radionuclide ventriculography, mean dose of diuretic, plasma sodium and urea concentrations, and peak oxygen consumption during exercise. Although all variables except cause of heart failure affected outcome on univariate analysis, multivariate analysis identified three variables that were statistically significant and independent predictors of outcome. In order of importance these were plasma sodium level, left ventricular ejection fraction and peak oxygen consumption. Even in this group of patients with severe heart failure, these variables were predictive of outcome.

Exercise Test↗
PubMed1992

Prevalence of heart failure in three general practices in north west London.

There is little recent information on the prevalence of heart failure in the United Kingdom. Assuming that patients with heart failure would be taking diuretic drugs all such patients were identified in three general practices in north west London. The practice records of these patients were examined to determine which patients had heart failure. Of the 30,204 patients served by the practices, 117 had heart failure, a prevalence of 3.9 per 1000 patients. The mean age of these patients was 74 years. The prevalence of heart failure among patients under 65 years of age was 0.6 per 1000 patients rising to 27.7 per 1000 among those aged 65 years and over. The aetiology of heart failure was considered to be coronary heart disease for 32% of patients, valve disease for 19%, hypertension for 6%, cor pulmonale for 4% and congenital heart disease for 2%. The aetiology for the remaining 37% of patients was unknown. Most patients were referred to hospital and only 20% had been treated solely by the general practitioner. An electrocardiogram and chest radiograph had been obtained for over 80% of patients but only 28% had an echocardiogram. Heart failure occurs primarily in elderly patients, and coronary heart disease is the dominant aetiological factor.

Aged↗
PubMed1992

Heart failure in a district general hospital.

The frequency, clinical characteristics, and outcome of patients admitted with heart failure to a district general hospital in North-West London serving a population of approximately 155,000 was assessed over a six-month period. The number of patients with heart failure was determined by both a prospective ward survey and a retrospective study of all patient records with diagnostic codes for heart failure or pulmonary oedema. During those six months, 2,877 patients were admitted to the medical and geriatric services of whom 140 (4.9%) had heart failure. Only 29 patients in heart failure were under the age of 65 years. In 86 patients the mode of presentation was acute pulmonary oedema. Fifty-two (37%) patients had an arrhythmia at the time of admission of whom 48 had atrial fibrillation. An electrocardiogram, a chest X-ray, and an echocardiogram were performed in 137, 136, and 81 patients respectively. The aetiology of heart failure was considered to be coronary artery disease (41%), valve disease (9%), hypertension (6%), cor pulmonale (4%), a dilated cardiomyopathy (1%), congenital heart disease (1%), thyrotoxicosis (1%), and unknown (36%). During the period of hospital stay 42 patients (30%) died; a further 20 patients (14%) died in a one-year follow-up. In a district general hospital heart failure is a common reason for admission and patients remain in hospital for a considerable time. Arrhythmias are commonly associated with heart failure. The prognosis is poor and the hospital mortality high. The management of heart failure is an important consideration in allocating hospital resources in a district general hospital.

Aged↗
PubMed1991

The effect of salinity on the phase behaviour of total lipid extracts and binary mixtures of the major phospholipids isolated from a moderately halophilic eubacterium.

The effects of molar NaCl concentrations on the phase behaviour of the total lipid extracts and binary mixtures of the major phospholipids, namely phosphatidylethanolamine (PE) and phosphatidylglycerol (PG), isolated from the moderately halophilic eubacterium, Vibrio costicola, grown in 1 M and 3 M NaCl containing media have been studied using X-ray diffraction and freeze-fracture electron microscopy. The effect of both the PE/PG ratio and alterations in fatty acid composition were examined by using binary mixtures which mimicked the PE/PG ratio found in the native bacterial membranes. We show that the samples exhibited complex phase behaviour, including the formation of non-bilayer phases, which depend upon the salinity of both the bacterial culture medium and the suspending solution. The total lipid from bacteria cultured in 1 M NaCl-containing medium and dispersed in 1 M NaCl exhibited a mixture of L alpha and hexagonal-II phases at the optimum growth temperature of the organism (i.e., 30 degrees C), whereas the same lipid dispersed in 3 M NaCl showed only a hexagonal-II phase down to a temperature of +3 degrees C. The total lipid extracted from 3 M NaCl cultures showed only lamellar phases over the temperature range studied (+50 degrees C to -50 degrees C), but the phase transition temperatures of the various lamellar phases were generally higher when the lipid was dispersed in 3 M compared with 1 M NaCl. The phase behaviour of the binary mixtures was similar but not identical to that of the corresponding total lipid extracts and it is suggested that the minor lipid components (diphosphatidylglycerol, lysophosphatidylethanolamine and lysophosphatidylglycerol) play a part in determining the phase behaviour of the native membranes. These results show that the PE/PG ratio and fatty acid composition of the individual phospholipids, which are normally regulated by Vibrio costicola in vivo in response to culture medium salinity, are both important in maintaining a stable bilayer structure within the membrane.

Eubacterium↗
PubMed1991

Mumps, measles and rubella vaccination: a pragmatic study.

The acceptability, adverse effects and uptake of MMR vaccine were assessed in an open pragmatic study. 96.5% of parents chose vaccination with MMR rather than monocomponent measles. Few parents could correctly name a complication of mumps (40.4%), measles (21.7%) or rubella (25.3%). In the three weeks following vaccination, 15.9% of infants had local reactions, 26.4% had rashes, and 30.3% fever. There was no increase in uptake of measles vaccination during the study, but it led to improvements in programme organisation which subsequently boosted coverage.

Attitude to Health↗
PubMed1990

Epidemiologic aspects of heart failure.

The prevalence of heart failure in Northwest London is 0.4%, a lower figure than that quoted for the United States. Heart failure is a common reason (5%) for medical admission to the hospital in the London area. The problem of heart failure is predominantly in persons over 65 years. Coronary artery disease is the most frequent cause, and hypertension is relatively uncommon. In those patients admitted to the hospital, the prognosis is poor.

Age Factors↗
PubMed1989

How accurate is computer-aided diagnosis?

A computer program for diagnosis of acute abdominal pain (CAD-A) was compared with an amended program (DIAG) and with clinical performance. The programs were tested at three Scottish hospitals, representing a range of practice, in 6962 cases. Accuracy of CAD-A lay in the range 48-59%, and of DIAG 56-62%. Clinical accuracy was constant at 65%. These figures suggest that computer systems based on Bayes' formula have no useful role in the diagnosis of acute abdominal pain.

Abdomen, Acute↗