PubMed Health⌕ Search

Biomedical subjects

O Scott

Publications and source records attributed to O Scott.

At least 19 recordsLinked to original sources
PubMed2001

Can brain-injured patients participate in an aerobic exercise programme during early inpatient rehabilitation?

OBJECTIVE: We investigated the capacity of brain-injured patients to participate in an aerobic exercise programme early after injury. DESIGN: Retrospective analysis of exercise achievements in patients participating in a randomized controlled trial. SETTING AND SUBJECTS: Ninety patients participated in an exercise training programme on a cycle ergometer at four inpatient neurological rehabilitation units for younger patients. At intake, impairments and function were rated on: Motricity Index, Ashworth Scale, Berg Balance Scale, Barthel Index and Functional Independence Measure. INTERVENTIONS: Patients cycled for up to 30 minutes three times weekly for 24-36 sessions over 12 weeks. MAIN OUTCOME MEASURES: Exercise performance was measured by: (a) number of sessions to achieve a cycling time of 30 minutes, (b) overall mean cycling time per session over 24 sessions and (c) mean time per session cycling at >60% of age predicted maximum heart rate (HR max) over 24 sessions. RESULTS: Fifty-five patients completed 24 sessions. Thirty-five withdrew, largely for logistic reasons, before completing training; they were significantly less disabled than the 55 who remained. Forty-four of the 55 patients trained for an average of at least 20 minutes per session, 18 training at >60% HR max for this time. There were no differences in performance on the three exercise parameters between two groups of patients with baseline Barthel scores of < or = 12 and > or = 13. CONCLUSIONS: Brain-injured patients with a range of disabilities have the capacity to participate in an exercise programme during early inpatient rehabilitation, though some may take longer to achieve adequate intensity of aerobic exercise.

Adolescent↗
PubMed1998

Recurrence risks in offspring of adults with major heart defects: results from first cohort of British collaborative study.

BACKGROUND: Congenital heart defects are generally assumed to have a multifactorial aetiology. We have tested this hypothesis by studying adults with heart defects and their families. METHODS: We identified 1094 patients who survived surgery for major cardiac defects before 1970. We chose individuals with disturbance of situs or segmental connection, with atrioventricular septal defect or with tetralogy of Fallot. After exclusion and non-participation, 727 individuals were traced. Each was visited by an investigator and completed a detailed questionnaire. If possible, all "normal" offspring were examined by a paediatric cardiologist. FINDINGS: The 727 individuals had 393 live offspring. There were 71 miscarriages and five terminated pregnancies. Overall, we found recurrent heart defects in 16 liveborn offspring--a recurrence risk of 4.1%. This result differed significantly from sibling risk (2.1%; p=0.021). More congenital heart defects occurred in the offspring of affected women than in those of affected men (p=0.047); when all malformations (cardiac and non-cardiac) in the offspring were taken into account the excess was more significant (p=0.032). We found an excess of miscarriages in the offspring of affected women (p=0.001). In tetralogy of Fallot, heart defects occurred in seven (3.1%) of 223 offspring, 12 (2.2%) of 539 siblings, five (0.3%) of 1575 second-degree relatives, and eight (0.3%) of 2728 third-degree relatives. INTERPRETATION: Our findings do not support a polygenic basis for all heart defects. Atrioventricular septal defect seems to be a single-gene defect and tetralogy of Fallot a polygenic disorder with a small number of interacting genes. Our data suggest that isolated transposition of the great arteries is a sporadic defect.

Adult↗
PubMed1986

Maternal antibodies against fetal cardiac antigens in congenital complete heart block.

An immunologic basis for congenital heart block has been proposed previously. To investigate the association between congenital heart block and maternal antibodies capable of crossing the placenta, we used immunofluorescence to examine serum samples from 41 mothers and 8 affected children, together with serum from controls, for antibodies to fetal cardiac tissue. Twenty-one mothers (51 percent) had IgG antibody reactive with fetal heart tissue, as compared with only 9 of 94 controls (10 percent; P less than 0.001). Three of 8 affected babies, but none of 50 healthy babies, had similar antibodies. The antibodies reacted with all myocardial tissue and were not directed specifically to the conduction system. They also reacted with other fetal tissues and could be distinguished from nuclear and smooth-muscle autoantibodies. We also observed a higher occurrence of antibodies to cytomegalovirus, but not to Epstein-Barr virus, in these mothers. Autopsy specimens from babies with congenital heart block examined by immunoperoxidase staining showed deposition of immunoglobulin and complement components in all cardiac tissues. These findings strengthen the case implicating immune reactivity related to maternal antibody in the development of some but not all cases of congenital heart block.

Antibodies, Antinuclear↗
PubMed1985

Normal intracardiac and great artery blood velocity measurements by pulsed Doppler echocardiography.

One hundred and 10 normal subjects were studied by pulsed Doppler velocimetry to determine the range of values of blood velocity across the cardiac valves and in the great vessels. Modal peak velocities of 1.55 m/s occurred in the left heart, but right heart peak velocities were lower. In most sites a statistically significant inverse relation between peak velocities and age or body surface area was found. Time to peak velcocity in the pulmonary artery and ascending aorta increased significantly with age and was shorter in the aorta than in the pulmonary artery. These data were developed to serve as standards for the assessment of values recorded in patients with congenital and acquired cardiac disease.

Adolescent↗
PubMed1984

Ambulatory electrocardiographic monitoring in 100 healthy teenage boys.

Ambulatory monitoring of the electrocardiogram in 100 healthy 14 to 16 year old boys showed heart rates ranging from 45 to 200 beats/minute during the day and from 23 to 95 beats/minute during sleep. Sinus arrhythmia was present in all cases and was the only variation noted in 17%. Sudden variations in the PP interval occurred in 41%, but a precise diagnosis of the mechanism was usually impossible; 15% had changes compatible with sinus arrest or temporary complete sinoatrial block, and one boy had a pattern compatible with type II second degree sinoatrial block. Escape rhythms were noted in 26%, first degree atrioventricular block in 12%, and second degree atrioventricular block (Mobitz type I) in 11%. Mobitz type II second degree atrioventricular block was seen on one occasion in one boy. Ventricular extrasystoles seen in 41% were of uniform morphology in 75% and multiform in 25%. Short episodes of ventricular tachycardia were recorded in 3%.

Adolescent↗
PubMed1984

Massive pericardial effusion in a hypothyroid child.

A child with Down's syndrome and long standing severe hypothyroidism had a massive pericardial effusion without cardiac tamponade. The effusion completely resolved with medical treatment without pericardiocentesis.

Adolescent↗
PubMed1984

Valvar stenosis in truncus arteriosus.

Twenty three morphological specimens of truncus arteriosus were examined for evidence of stenosis of the semilunar valve. One third showed good evidence of stenosis as judged by careful measurement of the valve orifice, the valve ring, and the maximum diameter of the truncus. Correlation with measured pressure gradients was poor, but angiography and cross sectional echocardiography were better predictors of stenosis. Stenosis was invariably associated with cusp dysplasia and was more common in valves with two or four cusps.

Angiocardiography↗
PubMed1984

Pulmonary artery velocity patterns in ductus arteriosus.

In 12 patients with ductus arteriosus a characteristic velocity pattern in the pulmonary artery was identified using pulsed Doppler echocardiography. This pattern, which was absent in 52 normal control subjects and 200 consecutive patients with cardiac lesions other than ductus, consisted of a pandiastolic velocity directed away from the transducer. This pattern is thought to represent the diastolic component of flow into the pulmonary tree which occurs as a result of the left to right shunt.

Adolescent↗
PubMed1983

Connective-tissue disease, antibodies to ribonucleoprotein, and congenital heart block.

The relation between congenital heart block and maternal connective-tissue disease was studied by antibody screening of serum samples obtained in connection with 45 cases of isolated congenital complete heart block. Serum was available from 41 mothers (17 who had connective-tissue disease and 24 who were healthy) and 21 children. Thirty-four mothers had antibody to a soluble tissue ribonucleoprotein antigen called Ro(SS-A), which was identified by immunodiffusion. Anti-Ro(SS-A) was found in seven of eight serum samples collected from affected children when they were less than three months old but in none of 13 samples obtained when these children were older. It appears that maternal anti-Ro(SS-A) antibody crosses the placenta and is a marker for risk of congenital complete heart block; its absence from maternal serum suggests that a child is unlikely to be affected. Anti-Ro(SS-A) or a related antibody is probably involved in the pathogenesis of congenital complete heart block.

Autoantibodies↗
PubMed1983

Calcification of glutaraldehyde-preserved porcine and bovine xenograft valves in young children.

Eight children (mean age, 7.6 years) had xenograft prosthetic valves inserted. All developed evidence of prosthetic valve obstruction requiring reoperation 18 to 55 months after insertion (mean, 32 months). At operation, all the valves were found to be heavily calcified. There were two perioperative deaths. Of two patients who had a second xenograft valve inserted, one died suddenly 12 months later. Gross calcification of the xenograft was found at postmortem examination. The other patient had evidence of mild xenograft calcification at follow-up 19 months postoperatively. Four of the ten calcified xenograft valves were of bovine origin (Ionescu-Shiley type); in these the calcific obstruction occurred significantly earlier than in the six porcine (Hancock) valves.

Aortic Valve Stenosis↗
PubMed1982

Coeliac disease associated with congenital heart disease.

Six children with congenital heart disease are described in whom poor growth was found to be due to small-bowel villous atrophy; none was in heart failure and only one was severely cyanosed. Growth improved in all 6 on a gluten-free diet. Gluten enteropathy may be more common than is realised in children with congenital heart disease, and jejunal biopsy should be undertaken early in any patient with poor growth and no heart failure to exclude the coexistence of the condition.

Celiac Disease↗
PubMed1981

Two chambered left ventricle. Three new varieties.

A short review of two chambered left ventricle is given, and this rare condition is briefly compared and contrasted with the more common condition involving the right ventricle. Three cases are described, each of which presents a new variety of subdivision of the left ventricle; in two of these the condition was first shown by angiocardiography. The first case had left heart hypoplasia with dysplastic stenosis of the mitral and aortic valves and severe endocardial fibroelastosis of the main left ventricular cavity. The second case also showed dysplasia of the left sided valves with pronounced endocardial fibroelastosis, and in addition there was a congenital malformation of the left lung. The third case showed a bizarre ventricular subdivision without other congenital malformations. The role of the intertrabecular myocardial sinusoids in the pathogenesis of some types of two chambered ventricle is discussed and this is considered to have been of significance in the first two cases. The third case possibly represented an intramyocardial aneurysm of obscure aetiology.

Female↗
PubMed1980

Angiocardiography with metrizamide in the neonate and infant.

The non-ionic contrast medium metrizamide was compared with a routine ionic medium (sodium methyl-glucamine diatrizoate) in a series of 16 patients with congenital heart disease, all under 11 kg body weight, undergoing angiocardiography. Despite a higher viscosity, metrizamide yielded images of equal quality to those of the ionic medium, and was clinically better tolerated. Metrizamide produced a significantly lesser effect on plasma osmolality, a parameter closely related to contrast medium toxicity. Other biochemical parameters showed insignificant changes. Metrizamide is therefore a more suitable contrast medium for angiocardiography and despite its cost should be considered for patients with serious congenital heart disease who are in poor clinical condition.

Angiocardiography↗