PubMed Health⌕ Search

Biomedical subjects

J Till

Publications and source records attributed to J Till.

14 recordsLinked to original sources
PubMed1992

Assessment of QT dispersion in symptomatic patients with congenital long QT syndromes.

It has been suggested that QT dispersion recorded on the surface electrocardiogram may be a predictor of arrhythmic events in patients with congenital QT prolongation. To evaluate this, 9 patients (6 female, mean age 17.6 years) with congenital long QT syndromes, all of whom had syncope and documented torsades de pointes, were studied. Patients were studied off treatment and during therapy with beta-blocking agents. Three patients were also studied after left stellate ganglionectomy. An age-matched control group was also studied. Good quality 12-lead electrocardiograms were recorded from all patients. For each lead, QT and RR intervals were measured, and QTc value was calculated. QT and QTc dispersions were calculated for each patient. Patients had a significantly longer mean QT interval compared with that of the control group (450 +/- 100 vs 359 +/- 63 ms; p = 0.015) at similar mean RR intervals (736 +/- 231 vs 783 +/- 289 ms), with a longer mean QTc value (0.53 +/- 0.08 vs 0.41 +/- 0.02 s1/2; p = 0.004). Patients also had longer QT and QTc dispersions compared with those of the control group (110 +/- 45 vs 43 +/- 12 ms [p = 0.004], and 0.108 +/- 0.03 vs 0.05 +/- 0.02 s1/2 [p = 0.002], respectively). QT and QTc dispersions on and off beta-blocking agents were not significantly different. Comparing patients with frequent and those with infrequent symptoms, there was no difference in QT or QTc dispersion either off treatment or during therapy with beta-blocking agents.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1992

Atrial flutter in the fetus and young infant: an association with accessory connections.

OBJECTIVE: To highlight the association between atrial flutter and accessory connections in the fetus and young infant. DESIGN: A retrospective review from January 1985 to January 1990. PATIENTS: Fetuses, neonates, and young infants with atrial flutter. RESULTS: Four fetuses and five infants presented with atrial flutter. In two fetuses and one infant sinus rhythm returned spontaneously. The other six required cardioversion. Three of them developed orthodromic atrioventricular re-entry tachycardia and each had evidence of an accessory connection. CONCLUSIONS: Because atrial flutter in the fetus and neonate is rare, the high incidence of accessory connections in this group points to a possible aetiology of "idiopathic" atrial flutter in this age group.

Atrial Flutter↗
PubMed1989

Efficacy and safety of adenosine in the treatment of supraventricular tachycardia in infants and children.

One hundred and seventeen episodes of supraventricular tachycardia in 50 children, including 28 infants, were treated with intravenous adenosine. Adenosine was prepared in a sterile solution of 0.9% saline (1 mg/ml) and given in incremental doses of 0.05 mg/kg every two minutes to a maximum of 0.25 mg/kg. Ninety of the 117 episodes were terminated. This included 88 of the 102 episodes of junctional tachycardia (79 of the 92 episodes of atrioventricular reentry tachycardia, seven of the eight episodes of atrioventricular nodal reentry tachycardia, and both of the episodes of long R-P' tachycardia). Only one of four episodes of His bundle tachycardia and one of the eight episodes of ectopic atrial tachycardia were terminated. None of the three episodes of atrial flutter were terminated. Side effects were frequent but mild and included transient complete atrioventricular block (less than 6 s), sinus bradycardia (less than 40 s), ventricular extrasystoles, flushing, nausea, headache, and respiratory disturbance. Reinitiation (within 5 s) of supraventricular tachycardia occurred in 13 of the terminated episodes. Although reinitiation limited its clinical efficacy in some patients, intravenous adenosine offered a safe and efficient method of rapid termination of most episodes of supraventricular tachycardia and in some cases facilitated diagnosis of the mechanism.

Adenosine↗
PubMed1987

Rapid and safe termination of supraventricular tachycardia in children by adenosine.

Adenosine (0.05-0.25 mg/kg intravenously) successfully terminated resistant supraventricular tachycardia (SVT) in three seriously ill newborn infants and one older child. Termination of tachycardia was achieved in each case within 20 s. Adenosine, unlike many other anti-arrhythmic agents, has no substantial negative inotropic effect under these circumstances and may become the drug of choice in haemodynamically compromised children with SVT. However, it has no value in prophylaxis against recurrent SVT.

Adenosine↗
PubMed1986

Screening for intrauterine growth retardation using ratio of mid-arm circumference to occipitofrontal circumference.

Uncritical application of standard weight percentile charts, derived from white infants, to infants from different ethnic groups may result in an overestimate of the incidence of intrauterine growth retardation in those groups. The ratio of mid-arm circumference to occipitofrontal circumference was studied in 194 babies (49 Asian, 58 black, and 87 white). In contrast with birth weight the ratio did not vary among the ethnic groups; it was also independent of sex. In a prospective study of 64 neonates whose weight was below the 10th percentile on standard charts the ratio of mid-arm circumference to occipitofrontal circumference was a more accurate predictor than weight of those infants who would develop symptoms associated with intrauterine growth retardation. The ratio of mid-arm circumference to occipitofrontal circumference therefore provides a simple, accurate, and cheap way of assessing intrauterine growth retardation in areas with a large multiethnic population, where birth weight varies greatly.

Anthropometry↗
PubMed1984

[Lesions of the gastric mucosa caused by blunt abdominal injury].

Within a casuistic is reported on an 8-year-old boy who suffered from an intestinal haemorrhage due to a blunt abdominal trauma. Due to the endoscopic possibilities which are nowadays at our disposal appeared an alteration of the gastric mucous membrane in our opinion conditioned by contusion which from the macroscopic standpoint let us think of an ulceration. Theoretical fundaments as well as the anamnesis and the clinical course are correlated with our opinion to this case.

Abdominal Injuries↗
PubMed1983

Phonatory and manual reaction times of women with idiopathic spasmodic dysphonia.

This investigation compared the simple reaction times of 10 idiopathic spasmodic dysphonic women and 10 normal-speaking women matched individually for age and handedness. The reaction time stimulus in all response conditions was the offset of a 1000-Hz pure tone. Two of the experimental conditions required right and left forefinger button pressing. The remaining four experimental conditions required phonatory responses. The nonspeech phonatory responses consisted of inspiratory phonation and expiratory throat clearing; the speech-like phonatory responses required abrupt initiation of the isolated vowel and the word. The spasmodic dysphonic patients differed (p less than or equal to .05) from their matched controls only during production of. The results are compared to previous reaction time investigations and are related to factors which potentially can influence sensory-motor pathways prior to and during speech.

Adult↗
PubMed1981

Laryngeal and manual reaction times of stuttering and nonstuttering adults.

This investigation compared the reaction times of thirteen stuttering and thirteen nonstuttering adults for forefinger button pressing, nonspeech vocal initiation, and speech-mode vocal initiation. The stutterers and nonstutterers were matched individually for age, sex, and handedness. The reaction-time stimulus in all response conditions was the offset of a 1000-Hz pure tone. Two of the experimental conditions required button pressing with the right and left forefingers. The remaining four responses required vocal-fold vibration. The nonspeech vocal activity consisted of inspiratory phonation and expiratory throat clearing. The speech-mode vocal activity required production of the isolated vowel and the word. The results demonstrated that stuttering and nonstuttering adults differed significantly only on tasks requiring speech phonation. These results are compared to previous reaction-time investigations and related to factors which may influence sensory-motor pathways prior to and during speech.

Adult↗
PubMedDate not supplied

A comparison of workload estimates using three methods of patient classification.

This research examined the equivalence of the workload estimates of three commonly used patient classification systems in nursing (GRASP, PRN and Medicus). Patient classification systems are used for program costing and formulation of the nursing budgets. The findings suggest that the estimates of absolute hours of care provided by the three systems differ significantly when all three tools are used on the same patient population, particularly in the Intensive Care Units (ICUs). The data suggest that these differences result from the weights assigned to individual indicators within each system. Although hours of care estimates are significantly different, they are highly correlated. This research suggests that the estimates of hours and costs provided by different patient classification systems may involve clinically important differences. These discrepancies could result in inequitable funding practices unless mechanisms are developed for showing the relationships between systems.

Evaluation Studies as Topic↗