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Biomedical subjects

G MacKenzie

Publications and source records attributed to G MacKenzie.

At least 37 records · Page 2Linked to original sources
PubMed1993

The incidence of child sexual abuse in Northern Ireland.

This is part of a major epidemiological survey of the reported incidence (new cases) of child sexual abuse in Northern Ireland. Based on multi-source methodology, the study used computer-based record linkage techniques to find the number of incident cases occurring in the Province in 1987. Reporters involved with the incident cases were interviewed by OEV who recorded details of the child, the abuse, and the abuser using a specially designed questionnaire. Age-sex specific incidence rates adjusted for potential misclassification were computed and allowance made for under-ascertainment. Overall, 408 Established cases were reported during 1987. The corresponding incidence rate for Northern Ireland was 0.9 cases per 1000 children. When Suspected and Alleged cases were compared with Established cases, a further 119 cases were allocated by discriminant function analysis to the Established group, and the rate rose to 1.16 per thousand. Selected reporters were interviewed about ascertainment which was estimated to lie between 62% and 74%. If the lowest level of ascertainment applied the corresponding incidence rate for Northern Ireland would increase to 1.87. These figures are higher than those currently reported elsewhere in the UK, but methodological differences in study design hamper interregional comparisons. A number of relevant methodological problems are discussed.

Adolescent↗
PubMed1993

Role patterns and emotional responses of women with ischemic heart disease 4 to 6 weeks after discharge from hospital.

Women comprise only a small percentage of subjects in studies of psychosocial responses to heart disease. Some research suggests women have higher rates of anxiety and depression post myocardial infarction than men. This descriptive-correlational study examined role enactment and emotional responses of nineteen women with ischemic heart disease four to six weeks after discharge from hospital. More specifically, the study examined the relationship among Physical Symptoms, Quality of Role Enactment, and Emotional Response. Study findings suggest subjects were generally satisfied with their role enactment. There were no relationships among the three study variables-Physical Symptoms, Quality of Role Enactment, and Emotional Response. However, women who experienced a myocardial infarction and those with other forms of ischemic heart disease differed in terms of physical symptoms and role enactment after discharge. Subjects did not report high levels of depression; yet, there was some indication of emotional distress. Interestingly, the first two weeks after discharge were described as the most difficult time. The results from this study point to areas of further research.

Adaptation, Psychological↗
PubMed1991

Long-term survival after resuscitation from ventricular fibrillation occurring before hospital admission.

Factors related to long-term (post-discharge) outcome following successful resuscitation from pre-hospital ventricular fibrillation by a physician-manned mobile coronary care unit were studied. Between 1 January 1966 and 31 December 1987, 190 patients were resuscitated from pre-hospital ventricular fibrillation (158 male; mean age 56 years). The aetiology of ventricular fibrillation was acute myocardial infarction in 131 patients (69 per cent), ischaemic heart disease without infarction in 48 (25 per cent) and other or unknown in 11 (6 per cent). Predicted actuarial survival rates at 1, 2, 5, 10 and 20 years were 76 per cent, 66 per cent, 41 per cent, 27 per cent and 12 per cent respectively. Of 128 recorded deaths over 20 years, 85 per cent were cardiac and 48 per cent were defined as sudden death outside hospital. Factors significantly associated with increased long-term mortality (p less than 0.05), based on analysis of 10 year actuarial life tables using the Lee-Desu statistic were ventricular fibrillation due to ischaemic heart disease without infarction rather than acute myocardial infarction, a history of previous myocardial infarction, a history of hypertension, digoxin and diuretic therapy before ventricular fibrillation and digoxin as discharge medication, and failure to stop smoking after discharge from hospital by patients who had been smoking prior to ventricular fibrillation. In addition, Cox's regression analysis showed that patient age greater than or equal to 60 years was significantly associated with increased long-term mortality. On multivariate analysis, factors independently associated with increased long-term mortality were ventricular fibrillation occurring before 1977, previous myocardial infarction or hypertension and digoxin as discharge medication.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1988

Effect of nifedipine on arrhythmias in the acute phase of myocardial infarction.

In a double-blind placebo-controlled trial to study the effect of nifedipine on ventricular arrhythmias among patients with acute myocardial infarction, 434 patients with suspected myocardial infarction were randomized within 6 h from the onset of chest pain to treatment with nifedipine (p = 217) or placebo (p = 217). During the 48-h treatment period, a 10-mg capsule containing active drug or placebo was administered sublingually every 4 h for 24 h, then orally every 4 h for the next 24 h. Acute myocardial infarction was confirmed in 295 patients (146 in the nifedipine group and 149 in the placebo group). Twenty-four hour ECG tape analysis during 1-5 h from onset of chest pain showed that there was no significant difference in the number of patients with ventricular ectopics, ventricular couplets, ventricular tachycardia (3-9 beats), self terminating or sustained ventricular tachycardia between the two treatment groups. Also during the greater than 5-24 h from onset of chest pain, the numbers of patients with ventricular ectopics, multifocal, bigeminal or couplets, self-terminating ventricular tachycardia or sustained ventricular tachycardia did not differ significantly. However, there was a significant reduction in the number of patients with short runs of ventricular tachycardia (3-9 beats) in the nifedipine-treated group. There was no significant difference among patients with ventricular fibrillation between the two treatment groups.

Adult↗
PubMed1988

Effect of nifedipine on enzymatically estimated infarct size in the early phase of acute myocardial infarction.

In a double blind placebo controlled trial, 434 patients with suspected myocardial infarction were randomised to treatment with nifedipine (n = 217) or placebo (n = 217) within six hours from the onset of chest pain. During the treatment period of 48 hours, a 10 mg capsule containing nifedipine or placebo was given sublingually every four hours for 24 hours, then orally every four hours for the next 24 hours. Acute myocardial infarction was confirmed in 295 patients (146 in the nifedipine group and 149 in the placebo group). The median delay time to intervention with nifedipine in patients with acute myocardial infarction was 111 minutes. Infarct size was assessed by the estimation of release of creatine kinase isoenzyme MB and creatine kinase from blood samples taken every four hours for 48 hours. The total mean (SEM) creatine kinase MB released was 406.4 (27.2) IU/l in the nifedipine group and 345.7 (20.5) IU/l in the placebo group. Total mean (SEM) creatine kinase released was 2749.6 (165.1) IU/l in the nifedipine group and 2698.4 (145.9) IU/l in the placebo group. In hospital mortality was similar for both the nifedipine and placebo groups (6.6% and 5.8% respectively). Treatment with nifedipine in the early phase of acute myocardial infarction seems to have no effect on enzymatically measured infarct size.

Aged↗
PubMed1988

Thallium scintigraphy in patients with angina at rest.

Sixty six patients with angina at rest were investigated by exercise electrocardiography, thallium scintigraphy, and coronary arteriography. A positive exercise electrocardiogram was highly predictive (93%) but poorly sensitive (52%) of coronary artery disease (greater than or equal to 50% stenosis). Thallium scintigraphy was as predictive of the presence of coronary artery disease (91%) but was also highly sensitive (91%). The diagnostic contribution of the thallium scan was greatest in those patients with an inconclusive exercise electrocardiogram without Q waves.

Adrenergic beta-Antagonists↗
PubMed1988

Fatal ischaemic heart disease in Belfast: a comparison of two community surveys.

Data from two community surveys in Belfast were used to compare all deaths attributed to ischaemic heart disease during two one-year periods (1965/66 and 1981/82). There was an increase in mortality in men of all ages from 3.3 to 4.4 per 1,000 population (33%) and in women from 1.6 to 3.1 per 1,000 population (94%). Only in men aged less than 70 years was the mortality rate unchanged (2.2 per 1,000 population). The proportion of deaths in persons whose fatal attack began outside the hospital was virtually unchanged (65% in 1965/66 compared with 69% in 1981/82). Survival time was markedly decreased in the later survey, as were delay times in initiating medical care. The increase in mortality probably is due to an increase in the incidence of acute myocardial infarction. The introduction of mobile coronary care in Belfast in 1965 seems to have had equal effects in reducing mortality inside and outside hospital.

Adult↗
PubMed1986

Survival to leave hospital from ventricular fibrillation.

In 125 consecutive patients with 173 arrests due to ventricular fibrillation, 53 survived to leave hospital. At the initial arrest and using univariate analysis, those who had primary ventricular fibrillation, had ventricular fibrillation less than 24 hours from the onset of symptoms, received the first DC shock less than 1 minute after the onset of ventricular fibrillation, who required less than 4 shocks to terminate the ventricular fibrillation, whose first established rhythm within the first minute of correction of ventricular fibrillation was atrial fibrillation, sinus rhythm or paced rhythm, or who were not receiving prior antiarrhythmic agents had a significantly improved survival to leave hospital (p less than 0.05). To predict survival to leave hospital using discriminant function analysis, the most significant factors ranking in order of importance at the time of the initial arrest were: less than or equal to 5 shocks to correct ventricular fibrillation, no prior antiarrhythmic therapy, primary ventricular fibrillation, and time from onset of ventricular fibrillation to first shock less than 1 minute. For the last arrest, the most significant factors were: no prior cardiac arrest, less than or equal to 5 shocks to correct ventricular fibrillation, no prior antiarrhythmic therapy, and primary ventricular fibrillation. The most significant factors measured at the time of the last arrest provided a better prediction of survival to leave hospital (sensitivity 77%, specificity 75%) than did similarly defined factors for the initial arrest (sensitivity 59%, specificity 89%).

Adolescent↗
PubMed1985

Long-term survival following cancer of the male breast in Northern Ireland. A report of 81 cases.

Eighty-one patients with cancer of the male breast were studied. The majority (79) presented with a mass in the breast and in 8 patients the tumor was found by chance. Two patients presented with serosanguinous discharge. Average duration of symptoms was 11.9 months. Thirty patients had Stage I, 25 had Stage II, 16 had Stage III, and 8 had Stage IV disease. Fifty-three patients had simple mastectomy, nine had lumpectomy, six had radical mastectomy, and five had biopsy only. Eight had no local surgery. Overall 5- and 10-year survival allowing for all causes of death was 38% and 17%, respectively. Cox's (1972) proportional hazard regression model was used to assess the contribution of various factors to survival. Age at presentation, postoperative hormone therapy, postoperative radiotherapy, site of the primary tumor within the breast, and type of local surgery did not contribute to survival. Only the stage of disease contributed to survival and did so in the expected direction.

Actuarial Analysis↗
PubMed1985

Prophylactic lidocaine in the early phase of suspected myocardial infarction.

Four hundred two patients with suspected myocardial infarction seen within 6 hours of the onset of symptoms entered a double-blind randomized trial of lidocaine vs placebo. During the 1 hour after administration of the drug the incidence of ventricular fibrillation or sustained ventricular tachycardia among the 204 patients with acute myocardial infarction was low, 1.5%. Lidocaine, given in a 300 mg dose intramuscularly followed by 100 mg intravenously, did not prevent sustained ventricular tachycardia, although there was a significant reduction in the number of patients with warning arrhythmias between 15 and 45 minutes after the administration of lidocaine (p less than 0.05). The average plasma lidocaine level 10 minutes after administration for patients without a myocardial infarction was significantly higher than that for patients with an acute infarction. The mean plasma lidocaine level of patients on beta-blocking agents was no different from that in patients not on beta blocking agents. During the 1-hour study period, the incidence of central nervous system side effects was significantly greater in the lidocaine group, hypotension occurred in 11 patients, nine of whom had received lidocaine, and four patients died from asystole, three of whom had had lidocaine. We cannot advocate the administration of lidocaine prophylactically in the early hours of suspected myocardial infarction.

Adult↗
PubMed1985

Pancreas preservation with TP-IV: a hyperosmolar colloid solution.

This study compares the efficacy of a new hyperosmolar colloid solution (TP-IV) with Euro-Collins solution for long-term (72 hr) hypothermic storage of canine pancreas autografts. Four experimental recipient groups and their survival (30-day study period) results were as follows: Gr. I (n = 6) pancreatectomized controls, without autotransplant (X +/- SD = 5.83 +/- 3.06 days); Gr. II (n = 6) fresh nonpreserved autografts (X +/- SD = 23.83 +/- 10.12 days, 5 of 6 greater than 30 days); and Gr. III (n = 7) and Gr. IV (n = 5) receiving pancreas autografts stored at 4 degrees C for 72 hr in either Euro-Collins or TP-IV, respectively (Gr. III, 13.85 +/- 9.04 days; Gr. IV, 21.2 +/- 12.37 days). The results appear to indicate that TP-IV is superior to Euro-Collins solution for 72-hr hypothermic storage of pancreas grafts. In fact, survival in the TP-IV-presented group was comparable to that of fresh, non-preserved autografts.

Animals↗