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Biomedical subjects

P Carson

Publications and source records attributed to P Carson.

At least 37 records · Page 2Linked to original sources
PubMed1988

Dissecting aneurysm of a right-sided descending aorta with a left-sided aortic arch.

A 66-year-old man presented with myocardial infarction. Chest X-ray showed a large mediastinal mass. Aortic dissection was suggested by a past history of chest trauma, but the mass was in a very atypical site. Dissection of an abnormally placed right-sided descending aorta was confirmed by computed tomography. The aortic arch lay on the left side. This rare combination of congenital and acquired heart disease led to diagnostic difficulty.

Aged↗
PubMed1987

Variation in mortality from ischaemic heart disease between England and Scotland.

A comparison of mortality from ischaemic heart disease under the age of 60 for 1980 to 1981 between the Grampian Health Board and the North Staffordshire Health Authority has been made. A total of 993 deaths was notified by death certificate from the two areas of similar population of which 434 were from Grampian and 559 from North Staffordshire. After examination of general practitioner and hospital case notes, autopsy reports and death certificates, nearly all (532) of the North Staffordshire deaths were accepted as being due to ischaemic heart disease but only three-fifths (263) of the Grampian deaths could be substantiated as there was inadequate information for the remainder. Deaths from ischaemic heart disease seem apparently to be twofold greater in North Staffordshire than Grampian but much of this discrepancy could be attributed to a widely different autopsy rate and to unavailability of case notes. Experience of this survey suggests that the results of other epidemiological investigations may be equally or even more unreliable.

Autopsy↗
PubMed1985

Exercise after myocardial infarction: long-term rehabilitation effects.

Long-term effects of an exercise programme for patients who had experienced myocardial infarction were investigated. Questionnaires were sent to 305 patients who during a three and a half year period had been invited to participate. Replies from 58 exercised patients, 13 who had dropped out, 75 controls and 69 who declined the invitation were analysed. The amount of exercise now being taken was positively correlated with scores on cardio-vascular and general health, and negatively correlated with symptoms during exercise and taking medication. The exercised group differed from the other groups in that a greater proportion were still taking heavy exercise. The latter scored significantly higher than the rest of the patients on most of the measures used. For effective long-term rehabilitation the problem of encouraging and enabling patients to continue vigorous exercise needs to be resolved.

Exercise Therapy↗
PubMed1985

Wound infection in elective biliary surgery: controlled trial using one dose cephamandole.

In a prospective randomized double-blind trial using a 1 g single dose of cephamandole versus placebo, given 1 h before surgery, the wound infection rate after elective surgery for gallbladder stones in 200 consecutive cases was 11%, being 15% in the placebo group and 7% in the cephamandole group (chi 2 = 4.03; P less than 0.05). The average hospital stay was 7.7 days in the absence of wound infection and 13.6 days in the presence of wound infection. Contaminated bile was significantly positively related to wound infection, and cephamandole significantly protected the culture-positive group from wound infection.

Adult↗
PubMed1984

High mean platelet volume after myocardial infarction: is it due to consumption of small platelets?

Seventy nine men surviving after sustaining a myocardial infarction in 1982, and who had at that time had raised mean platelet volumes compared with controls, were followed up after 18 months. The shape of each man's platelet distribution curve was calculated from the mean platelet volume, platelet count, and platelet distribution width. The calculated curves were in close agreement with the curves plotted by the Coulter counter from the raw data. These curves did not differ significantly from those of a current control group, but the curves plotted from the variables measured at the time of myocardial infarction in 1982 showed a deficit of platelets in the volume range 5-12 fl amounting at maximum to 30% (p less than 0.0001); there were no significant differences above 12 fl. The deficit of small platelets became more appreciable during initial admission, was less at one month's follow up, and had disappeared at one year. The deficit of small platelets is probably an effect rather than a cause of infarction.

Blood Platelets↗
PubMed1983

Postoperative wound infections: a study of bacteriology and pathogenesis.

Of 200 patients, 6.5% were skin carriers of Staphylococcus aureus and 3.5% became skin carriers after admission. Development of skin carrier state was associated with a long preoperative hospital stay. A second study of 275 cases showed that skin carriers of S. aureus had a significantly higher subsequent staph wound infection rate than non-carriers, but nose and/or throat carriers of S. aureus did not. Peroperative wound contamination was a significant factor in the subsequent development of wound infection. In clean surgery the infection rate was 5.9%. Both wound contamination and infection was due to gram positive organisms, usually S. aureus. When the gastrointestinal or biliary tract had been opened, the infection rate was 28%, the usual contaminating and infecting organisms were enteric and only occasionally S. aureus. There is a need for improved methods of minimizing peroperative wound contamination.

Bacteriological Techniques↗
PubMed1982

Epidemic of hospital-acquired infection due to methicillin-resistant Staphylococcus aureus in major Victorian hospitals.

During 1979, the Victorian Health Commission received reports of a rising proportion of methicillin-resistant Staphylococcus aureus (MRSA) isolates from an increasing number of institutions. At least 31 metropolitan hospitals were involved, and six of these reported MRSA totaling between 20% and 40% of all Staph. aureus isolates. Since that time, the problem has continued. In some university teaching hospitals, strains of MRSA now cause from 200 to 300 new cases of hospital-acquired infection each year. Sepsis occurs mainly in patients who underwent surgery, premature neonates and in the immunocompromised or debilitated patients. The organism involved is multiresistant. Recent isolates show increasing resistance, particularly against gentamicin, chloramphenicol and, more lately, fusidic acid and rifampicin. Only vancomycin can be relied upon for empirical treatment. There is concern that increasing use of vancomycin will select vancomycin-resistant strains of MRSA, so that, in the near future, there may no longer be any effective antibiotic therapy against hospital staphylococci.

Australia↗
PubMed1982

Exercise after myocardial infarction: a controlled trial.

Six weeks after acute myocardial infarction, 303 men were randomly divided into exercise and control groups. The exercise group attended the hospital gymnasium twice weekly for a three-month supervised exercise course. Both groups were exercise tested before and after the course and at subsequent follow-up. The exercise group increased their physical fitness greatly compared with the control group. Eight per cent of the exercise group died during the period of follow-up, compared with 14 per cent of the control group; this difference is not significant. There was an apparent improvement in mortality in those with inferior MI who completed the exercise course, which was not seen in those with MI in other sites. For many patients after MI progressive exercise is safe, improves physical fitness and may reduce mortality for those after inferior MI.

Clinical Trials as Topic↗
PubMed1978

Assessing the psychological effects of an exercise training programme for patients following myocardial infarction: a pilot study.

During a study investigating physiological and other effects of an exercise programme for coronary patients, a questionnaire was administered. Preliminary analysis had suggested some improvement in the patients' morale, but in view of the possible relevance of a number of psychological variables it was decided to carry out further analysis on the available data. The coefficient of discrimination was computed for 32 patients. For 19 patients correlations were computed between scores on subjective fitness, symptoms, anxiety, interest in sex, if at work, age, weight, and workload achieved at a given heart rate. The questionnaire appeared to have satisfactorily high internal and external validity. Patients with a high 'morale' score tended to achieve a greater increase in workload over the course. Although cause and effect cannot be unequivocally assigned, the association is felt to be important, and research is continuing.

Anxiety↗