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Biomedical subjects

R P Anderson

Publications and source records attributed to R P Anderson.

10 recordsLinked to original sources
PubMed1979

Reversal of exertional hypotension after coronary bypass grafting.

A decrease in systolic blood pressure that occurs with treadmill exercise testing may be a sign of reversible ischemic left ventricular dysfunction. To test this hypothesis, we examined retrospectively the postoperative treadmill responses of 37 patients who had exertional hypotension (end exercise systolic blood pressure less than or equal to initial preexercise levels) before coronary arterial bypass grafting. This group of 37 patients was characterized preoperatively by an abnormal exercise electrocardiogram (36 patients), multiple vessel occlusive disease (36 patients) and a normal ejection fraction at rest (32 patients). Postoperative exercise tests showed improvement in hemodynamic and electrocardiographic changes with reversal of exertional hypotension (33 patients), and conversion to a normal exercise electrocardiogram (29 patients). Coronary bypass surgery can be expected to reverse exertional hypotension in patients with symptomatic angina pectoris and evidence of ischemia in the exercise electrocardiogram.

Adult↗
PubMed1978

Field dependence and blood cholesterol: an expansion.

In a pilot study of 65 newly admitted psychiatric patients the first author evaluated the relationship between cholesterol, uric acid, and field dependence. The results suggested that high uric acid and low cholesterol individuals were more field independent whereas low uric acid and high cholesterol individuals were more field dependent. However, the differences were influenced mostly by the values of cholesterol and little by the uric acid. We have now expanded the sample to 229 consecutive admissions excepting only in-patients that were alcoholics or taking medication that has effects on any of the dependent variables. Included were age, ponderal index (a ratio of height and weight), and sex. For the whole group, field dependence correlated highly with age and cholesterol but less with blood uric acid. Dividing the sample by sex the situation changed. For males field dependence did not correlate with any of the other variables. However, for the females field dependence showed a positive correlation with cholesterol and age and with cholesterol even after correcting for age. Diagnoses did not correlate with any other variables except field dependence as an analysis of variance showed an incrase of field dependence when the patients were divided into three groups: (1) schizophrenics, (2) miscellaneous (including personality disorders), and (3) affective disorders. Again, these results demonstrated no relationship of field dependence with blood uric acid.

Adolescent↗
PubMed1977

Medical vs. urgent surgical therapy for acute coronary insufficiency: a randomized study.

Forty-two patients with acute coronary insufficiency (high risk subgroup) were randomly assigned to urgent coronary bypass surgery or to initial medical therapy followed by elective coronary bypass at four months if indicated at that time for relief of incapacitation angina pectoris. Coronary bypass performed on an urgent basis offered no advantage in preventing early myocardial infarction or death. The acute illness was resolved without permanent complications in most patients by either urgent bypass surgery or intensive medical therapy. The functional capacity at four months as assessed by objective testing was much greater in the urgent surgical group. Elective bypass surgery was carried out at that point in about half of the medical patients due to persistent incapacitating angina. Later serious complications have continued to occur in the medical patients but have not occurred up to the present time in the urgent surgical patients.

Angina Pectoris↗
PubMed1975

Medical versus surgical therapy for acute coronary insufficiency. A randomized study.

Forty patients with acute coronary insufficiency, including continued angina at rest and reversible ischemic electrocardiographic changes after hospitalization ("high-risk" subgroup), were randomly allotted to medical therapy or urgent surgical coronary bypass groups. In four months there were no deaths and two myocardial infarctions in 19 medical patients and one death and three myocardial infarctions in 21 surgical patients. Left ventricular ejection fraction did not change significantly in either group. The surgical patients had significantly higher functional capacities at four months as judged by lower symptomatic functional class (P less than 0.01), higher exercise angina threshold (P less than 0.001), higher pacing angina threshold (P less than 0.0001), and higher myocardial lactate extraction during pacing (P less than 0.0001). Initial medical management of patients with acute coronary insufficiency followed by elective coronary bypass in patients with continued disabling angina pectoris is a reasonable alternative to emergency bypass.

Acute Disease↗