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Biomedical subjects

H Wolfenden

Publications and source records attributed to H Wolfenden.

7 recordsLinked to original sources
PubMed2002

Systematic review of beating heart surgery with the Octopus Tissue Stabilizer.

The safety and efficacy of off-pump coronary artery bypass surgery with the aid of the Octopus Tissue Stabilizer (Octopus OPCAB), in comparison to conventional on-pump coronary artery bypass surgery (CPB-CABG), was examined by a systematic assessment of the peer-reviewed literature. The limited comparative data suggested that there was no difference in safety outcomes between Octopus OPCAB and CPB-CABG. The paucity of efficacy data reported in the higher level comparative studies meant that it was impossible to assess whether Octopus OPCAB was more efficacious than CPB-CABG. The evidence base for the procedure was deemed inadequate and an audit of the procedure was recommended.

Cardiopulmonary Bypass↗
PubMed2001

A National Cardiac Surgery Database: why, how and when?

As users of large amounts of public funding, surgeons are increasingly being required to justify their activities. The provision of accurate risk-stratified data on cardiac surgical procedures and their outcomes allows for government review while also providing a means of achieving potential improvements to strategies for the management of higher risk patients. In addition, accurate data will allow for the appropriate assessment of results that fall outside acceptable benchmark standards. A management strategy may then be implemented, following peer-review processes, to examine the outlying results on an anonymous basis. The dataset currently employed in the Victorian Database is derived from USA and UK models, and it will be used for the development of a national database. This project has Federal Government support in principle, and, it is hoped, its eventual financial backing.

Journal Article↗
PubMed1986

Encainide disposition in patients with chronic cirrhosis.

The antiarrhythmic agent encainide undergoes extensive first-pass hepatic metabolism after oral dosing. The active metabolites O-desmethylencainide and 3-methoxy-O-desmethylencainide are formed in subjects who are extensive metabolizers (EMs), a phenotypic trait that cosegregates with that of debrisoquin. Because of the possibility that drug metabolism is altered by liver dysfunction, the disposition of encainide and its metabolites was studied in six such EMs with cirrhosis and compared with that in eight normal subjects of the same phenotype. Patients with cirrhosis had lower systemic and oral clearances of encainide, resulting in a threefold increase in oral bioavailability. The plasma concentration of encainide was significantly higher among the patients with cirrhosis, whereas the plasma levels of the respective metabolites were comparable with those in normal subjects, resulting in no change in the patient's ECG intervals. Encainide is, therefore, an example of a drug in which cirrhosis causes a three- to fourfold increase in parent drug concentrations. However, because no change occurs in the levels of the pharmacologically active metabolites, dosage adjustment is probably not required in patients with cirrhosis.

Administration, Oral↗