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Biomedical subjects

P Magee

Publications and source records attributed to P Magee.

27 records · Page 2Linked to original sources
PubMed1991

An unusual presentation of systemic lupus erythematosus.

A case of right hemiparesis in a 22-year-old, caucasian male is presented. Echocardiography and an indirect left ventriculogram revealed a mass in the left ventricle which was eventually removed at surgery. Histology of the ventricular wall revealed thrombus superimposed on a full thickness myocardial infarction with florid intimal proliferation of small arteries. This histological picture suggested a diagnosis of systemic lupus erythematosus. Serum immunology revealed raised antibody titres in keeping with systemic lupus erythematosus. This is an unusual presentation where the only manifestation of disease was hemiparesis secondary to an embolic episode, from thrombus in the left ventricle subsequent to a small localised myocardial infarct.

Adult↗
PubMed1990

Coronary arteriography in a district general hospital: feasibility, safety, and diagnostic accuracy.

OBJECTIVE: To determine the feasibility, safety, and diagnostic accuracy of coronary arteriography in the radiology department of a district general hospital using conventional fluoroscopy and videotape recording. DESIGN: Observational study of the feasibility and safety of coronary arteriography in a district general hospital and analysis of its diagnostic accuracy by prospective within patient comparison of the video recordings with cinearteriograms obtained in a catheter laboratory. SETTING: Radiology department of a district general hospital and the catheter laboratory of a cardiological referral centre. SUBJECTS: 50 Patients with acute myocardial infarction treated with streptokinase who underwent coronary arteriography in a district general hospital three (two to five) days after admission. 45 Of these patients had repeat coronary arteriography after four (three to seven) days in the catheter laboratory of a cardiological referral centre. MAIN OUTCOME MEASURES: Incidence of complications associated with catheterisation and the sensitivity and specificity of video recordings in the district general hospital (judged by two experienced observers) for identifying the location and severity of coronary stenoses. RESULTS: Coronary arteriograms recorded on videotape in the district general hospital were obtained in 47 cases and apart from one episode of ventricular fibrilation (treated successfully by cardioversion) there were no complications of the procedure. 45 Patients were transferred for investigation in the catheter laboratory, providing 45 paired coronary arteriograms recorded on videotape and cine film. The specificity of the video recordings for identifying the location and severity of coronary stenoses was over 90%. Sensitivity, however, was lower and for one observer fell below 40% for lesions in the circumflex artery. A cardiothoracic surgeon judged that only nine of the 47 video recordings were adequate for assessing revascularisation requirements. CONCLUSIONS: Coronary arteriography in the radiology department of a district general hospital is safe and feasible. Nevertheless, the quality of image with conventional fluoroscopy and video film is inadequate and will need to be improved before coronary arteriography in this setting can be recommended.

Aged↗
PubMed1988

Anaphylaxis following "Hexabrix" during routine coronary angiography.

A case is described of an anaphylactic reaction to "Hexabrix 320" radiographic contrast medium in a patient undergoing routine coronary angiography. The case is reported because such reactions to "Hexabrix" are considered rare, because the patient was pretreated with hydrocortisone and chlorpheniramine, and because of the continuous monitoring that occurred during the procedure.

Aged↗
PubMed1987

Intravenous digital subtraction angiography in the diagnosis and management of acute aortic dissection.

Eleven patients presenting with the clinical diagnosis of suspected aortic dissection underwent intravenous digital subtraction aortography. In nine patients digital subtraction angiography (DSA) was performed as the investigation of first choice. In five of these the diagnosis was confirmed with this technique alone and surgical repair was undertaken without further investigation. Direct cine aortography was also undertaken in the other four patients and confirmed the DSA findings, demonstrating aortic dissection in one case and no dissection in three others. In two of the eleven patients, direct cine aortography was performed as the initial investigation. The results of subsequent digital aortography concurred in both cases, aortic dissection being demonstrated in one patient. In two cases, despite normal cine and digital aortography, aortic dissection was confirmed by computed tomography. We have found DSA to be a valuable technique for diagnosing aortic dissection, with no false positive or false negative findings when compared to direct cine aortography. Since it is a less traumatic procedure than direct aortography it should be the investigation of choice if computed tomography is not immediately available.

Aortic Dissection↗
PubMed1985

Randomised placebo controlled trial of aspirin and dipyridamole in the prevention of coronary vein graft occlusion.

Treatment with the combination of aspirin and dipyridamole is believed to reduce the incidence of coronary vein graft occlusion. A double blind randomised controlled trial was carried out in which aspirin 990 mg and dipyridamole 225 mg daily or placebo were added to the routine postoperative management (warfarin for three months) of 320 patients undergoing coronary bypass grafting. The trial treatment was given for 12 months, after which the results were assessed by coronary and graft angiography. The two randomised groups, each of 160 patients, were comparable in age, sex, symptomatic state, angiographic findings, and operative procedure. Repeat coronary arteriography was carried out on 266 patients, 133 in each group. All grafts and distal anastomoses were patent in 68% (91/133) of the placebo patients and in 75% (100/133) of those receiving active treatment. Overall graft patency was 87% (306/352) and 89% (342/385) respectively. Retrospective subgroup analysis showed patency rates of 72% (26/36) and 78% (39/50) of grafts to vessels requiring preliminary endarterectomy, and 80% (36/45) and 91% (40/44) of distal anastomoses to vessels measured at operation to have a diameter of less than or equal to 1 mm. None of these differences was significant at the 5% level. Thus in this group of patients with high graft patency rates, treatment with aspirin and dipyridamole conferred no appreciable advantage.

Adult↗
PubMed1985

Reoperation for angina after previous aortocoronary bypass surgery.

A retrospective study was carried out of the outcome of 102 patients who underwent a second operation for myocardial revascularisation, necessitated by persistence or recurrence of intractable angina after their first coronary bypass procedures. Operative mortality was 2%. During follow up of the survivors (mean interval 36.4 months) five died, two after further operation, and five underwent further surgery. Sixty eight patients reported an improvement in their symptoms, 57 of whom claimed to have little or no angina. Less favourable results were recorded for those patients reviewed with longer follow up. No useful indicators of prognosis were identified. The problem of angina in patients who have already received bypass grafts is likely to increase as more revascularisation surgery is performed. Reoperation offers a reasonable prospect of helping some of these patients, but not all will be suitable. Their long term prognosis remains uncertain.

Adult↗
PubMed1985

Bypass grafting to the right coronary artery with and without endarterectomy: patency at one year.

Between January 1979 and December 1981, 142 patients undergoing surgery to the right coronary artery agreed to have repeat coronary arteriography one year later. Thirty patients underwent combined endarterectomy and bypass grafting to the right coronary artery. The patency of these grafts was compared with that of grafts in 69 patients undergoing direct grafting to the right coronary artery and in 43 with grafting to the posterior descending coronary artery. There were two hospital deaths and one late death. No patients developed new inferior Q waves on the electrocardiogram. Repeat coronary arteriography at one year showed that 21 (72%) of the 29 grafts were patent after combined endarterectomy and bypass grafting to the right coronary artery. Sixty three (94%) grafts to the right coronary artery and 40 (93%) grafts to the posterior descending coronary artery were patent at one year. Direct grafts to the right coronary artery or its posterior descending branch had a significantly higher patency rate at one year than grafts to the endarterectomised right coronary artery. Graft patency after the combined procedure correlated with the extent of atherosclerosis in the posterior descending coronary artery. It was not influenced by treatment with platelet antagonists. Endarterectomy of the right coronary artery was most successful when it allowed a single graft to perfuse both the large posterior descending and left ventricular branches.

Adult↗
PubMed1972

Survey of school meals.

A Survey of 48 schools in South-east England showed that the protein and energy contents of the school meals were well below the standards set by the Department of Health. It was found that 7.4% of the children did not have breakfast. One school provided meals twice the average size, and the food was eaten. About 10% of the food offered was wasted.

Calcium, Dietary↗