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H Joffe

Publications and source records attributed to H Joffe.

5 recordsLinked to original sources
PubMed1994

Late ventricular arrhythmia is rare after early repair of tetralogy of Fallot.

OBJECTIVES: This study was conducted to describe the incidence of ventricular arrhythmia during prospective long-term follow-up in a group of patients who had repair of tetralogy of Fallot during early childhood. BACKGROUND: Ventricular arrhythmia has been a common finding in patients who have undergone repair of tetralogy of Fallot in late childhood or as adults. Whether earlier repair lowers the incidence of late ventricular arrhythmia or late sudden death is unknown. METHODS: Twenty-nine asymptomatic patients who underwent repair at age 1.2 to 7.7 years (mean [+/- SD] age 4 +/- 1.4 years) between 1979 and 1984 were studied. Twenty-one patients had simple repair (Group A), and eight had complex or multiple operations (Group B). All had ambulatory electrocardiographic monitoring preoperatively, postoperatively, at early follow-up (after 4.2 +/- 1.3 years) and again at late follow-up (after 11.8 +/- 1.3 years). At late follow-up, 28 subjects also underwent echocardiography, and 26 had an exercise test. RESULTS: No patient had significant ventricular arrhythmia (> or = modified Lown grade 2) before or immediately after repair. There was no significant increase in the incidence of arrhythmia at early and late follow-up (14% to 28%), but at each of these periods the incidence of ventricular arrhythmia was higher in Group B patients (3 [43%] of 7 vs. 1 [5%] of 22 with early repair, p = 0.03; 6 [75%] of 8 vs. 2 [10%] of 21 with late repair, p = 0.001). No patient had symptoms of arrhythmia, and there were no sudden deaths. Late ventricular arrhythmia did not correlate with estimated right ventricular systolic pressure, outflow tract gradient or degree of pulmonary incompetence or right ventricular dilation. On exercise, 5 (19%) of 26 patients had ventricular premature complexes at low levels of exercise that were suppressed at maximal exercise in all patients. CONCLUSIONS: Late ventricular arrhythmia is rare in patients with successful early correction of tetralogy of Fallot, unless complex or multiple operations are performed.

Adolescent↗
PubMed1989

Emotional factors in pregnancy.

Most writings on pregnancy detail the physical changes a woman undergoes during this period. This review shifts the focus to look specifically at emotional factors involving both the mother and father. Many general practitioners, obstetricians and paediatricians are unaware of and therefore insensitive to the development crisis ushered in by the state of pregnancy and so cannot offer emotional support to the couple at a time when they may require assistance.

Emotions↗
PubMed1982

The admission of the elderly to places of care: a socio-psychiatric community survey.

Elderly persons over the age of 60 who were admitted for psychiatric care were compared with a random sample of persons living in the same community in respect of psychiatric, medical and socio-economic variables. The group admitted to hospital for psychiatric reasons was very similar to the latter in general characteristics. However, those people admitted to old age homes, which are the other major resource of psychiatric illness, constitute a distinctly separate population, being older and having considerably more physical illnesses and socio-economic problems. Factors predicting admission to an old age home were largely irremediable age-related conditions (dementia, physical infirmity, etc.), but there were also adverse social circumstances, including marked isolation and a lack of social and emotional support. A comparative analysis of the many psychiatric, social and medical factors is presented, with particular reference to reasons for referral and prevention of admission.

Aged↗
PubMed1981

Reasons for referral of the elderly for psychiatric hospitalization.

The reasons for referral of elderly persons to a psychiatric hospital in Cape Town were investigated in respect of behavioural difficulties, impairment of function, psychiatric diagnosis and the attitudes and understanding of relatives and caring agents. Confused behaviour was the most common reason for admission, followed by depression, and anxiety symptoms were frequent. An impaired ability to manage their daily lives was a factor in 90% of cases. In general, referrals were appropriate and families showed a considerable ability to put up with disturbed behaviour. However, manifestations of anxiety and depression often went unrecognized and skill in handling difficult behaviour in old-age homes was often lacking. It was considered that a better level of general medical care would have obviated the need for admission in several cases. Response to a short period of hospitalization reduced the degree of impairment very considerably, even in patients with organic brain damage.

Aged↗