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Biomedical subjects

G S Hale

Publications and source records attributed to G S Hale.

At least 19 recordsLinked to original sources
PubMed1980

Shortened cardiac rehabilitation: a three year experience.

One-hundred-and-twenty-four (19%) of patients with acute myocardial infarction seen in a three year period from 1975 to 1978 were considered low risk patients suitable for rapid mobilisation, early discharge, and early exercise testing. Their mean long term Norris Prognostic Index was 3.2; the mean date of discharge was 9.6 days, and the mean date of exercise testing was 10.5 days. There were seven deaths and nine non-fatal recurrent myocardial infarctions in a mean follow up time of 14.2 months. These events were best predicted by a history of angina prior to myocardial infarction or radiological cardiomegaly detected in the CCU. Altogether 98 (80%) of the patients returned to work at a median time of six weeks after their infarct. The nett effect of the team activity has been to reduce the need for referral to the National Heart Foundation Assessment Centre from an average of 15 patients per year to an average of two per year.

Angina Pectoris↗
PubMed1968

Streptokinase therapy in acute major pulmonary embolism: effectiveness and problems.

Eighteen patients with major pulmonary embolism were treated with streptokinase infused by a catheter or given intravenously. Fourteen showed clinical improvement and 12 out of 16 patients investigated showed definite angiographic improvement after 24 to 48 hours of treatment with streptokinase. The angiographic improvement following streptokinase contrasted with the lack of this in three patients after 24 hours of heparin treatment.Resolution following streptokinase therapy was most noticeable in patients treated shortly after a single embolic episode, and was least marked in those with recurrent embolism complicated by associated cardiac or pulmonary disease. Of the four patients who failed to improve, two died and two had pulmonary embolectomy and survived.The results suggest that streptokinase therapy is practicable provided that adequate laboratory control is available, and that it hastens early resolution in acute major pulmonary embolism.

Acute Disease↗
PubMedDate not supplied

The surgical treatment of infective endocarditis.

We have reviewed 108 cases of bacterial endocarditis treated surgically since 1968. The mean age of the patients was 47.7 +/- 15.6 years (+/- SD) (range, 14-79 yr). Seventy-seven percent were male. The most common causative organisms were staphylococci (46%), streptococci viridans group (5%), and other streptococci (20%). Forty-five percent, 25%, and 13% of patients had native aortic valve, native mitral valve, or native double valve (AV/MV) involvement, respectively. Eighteen patients had prosthetic valve endocarditis. No patient underwent surgery for tricuspid valve endocarditis. Seventy-three patients were considered to have active endocarditis (AE) (positive blood or tissue cultures and/or annular abscess). The 35 remaining patients had healed endocarditis (HE). Preoperative complications in patients with either AE or HE were stroke (11%, 11%), renal failure (33%, 3%; p less than 0.001), pulmonary edema (83%, 34%; p less than 0.001), anemia (36%, 8%; p less than 0.01), and inotrope dependence (22%, 6%; p less than 0.05). Hospital mortality for native valve AE was 19.5% (11/56), and for healed endocarditis, 5.7% (2/35). Independent predictors of hospital mortality were inotrope dependence (p less than 0.001), annular abscess (p less than 0.01), pulmonary edema (p less than 0.01), and staphylococcal infection (p less than 0.05). The 5-year actuarial survival for operative survivors was 68.4 +/- 7.5% (AE) and 78.3 +/- 9.2% (HE). We conclude that the operative mortality for patients with continuing sepsis is high and that surgery should be undertaken early in staphylococcal endocarditis. If surgery is successful, then the long-term prognosis is good.

Adolescent↗