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Biomedical subjects

R Wray

Publications and source records attributed to R Wray.

At least 37 records · Page 2Linked to original sources
PubMed1991

The successful surgical repair of a ruptured interventricular septum following a myocardial infarct in an 89 year old man.

This case report describes the successful repair of an acquired ventricular septal defect following an anterior full thickness myocardial infarct in an 89 year old man. Four months after the infarct the patient was in severe congestive cardiac failure (NYHA Class IV), despite medical treatment, with signs of a ventricular septal defect. This was confirmed by echodoppler and cardiac catheterization. Surgical repair of the ventricular septal defect was performed. He made an uncomplicated recovery and two and a half years later is well and active. We believe he is the oldest patient who has had this operation successfully.

Aged↗
PubMed1989

Clinical efficacy of xamoterol, a beta 1-adrenoceptor partial agonist, in mild to moderate heart failure. U.K. Xamoterol Study Group.

The clinical efficacy of xamoterol, alpha beta 1-adrenoceptor partial agonist, was determined in a multicentre double-blind, randomized, parallel group study of 240 patients with mild to moderate heart failure. At entry, 62% of patients were receiving diuretics (thiazides, or loop diuretics at a dose no greater than the equivalent of 80 mg of frusemide); 32% were taking nitrate formulations and 14% digoxin for control of atrial fibrillation. Assessments were carried out after a 1-week placebo run-in and after 3 months of treatment with either xamoterol or placebo. 198 patients completed the study of whom 186 had valid exercise tests. Mean exercise duration increased by 7% after placebo and by 19% after xamoterol during a progressive treadmill exercise protocol. Xamoterol significantly reduced peak exercise heart rate compared with placebo. Subjectively, there was improvement in breathlessness on the visual analogue scale after treatment with xamoterol compared with placebo, but no change in fatigue. We conclude that xamoterol produces sustained improvement in symptoms and exercise duration in mild to moderate heart failure.

Adrenergic beta-Agonists↗
PubMed1983

Comparative clinical trial of bemetizide/triamterene and cyclopenthiazide/potassium chloride combinations in patients with mild to moderate hypertension.

A double-blind trial was carried out to compare the combination of 25 mg bemetizide plus 50 mg triamterene ('Hypertane') and 0.25 mg cyclopenthiazide plus 600 mg potassium chloride ('Navidrex' K) in the treatment of mild to moderate essential hypertension. Two well matched groups of patients were treated for periods of 6 weeks with one or other of the drugs under test. There were 2-week placebo run-in and run-out periods. Blood pressure and laboratory investigations were performed every 2 weeks during the trial period. Both treatments resulted in similar overall statistically significant reductions in blood pressure during the trial. With bemetizide/triamterene, mean lying blood pressure decreased by 11.1/11.2 mmHg and mean standing blood pressure by 15.9/10.3 mmHg; with cyclopenthiazide/potassium chloride the corresponding reductions were 14.9/12.1 mmHg and 9.1/11.7 mmHg. The fact that some of the observed overall reduction seen with both drugs was due to 'placebo effect' is discussed but the clinical importance of overall changes is stressed. There were no significant differences between changes in blood pressure with the two treatments. Biochemical changes were those expected with thiazide diuretics. However, the decrease in potassium and increases in urea and uric acid levels were less with bemetizide/triamterene than with cyclopenthiazide/potassium chloride. Clinical tolerance of both treatments was good.

Adolescent↗
PubMed1982

Echocardiographic studies in anaemic patients before and after blood transfusions.

Echocardiographic studies were undertaken in 15 patients with acute blood loss and 15 patients with chronic anaemia, before and after blood transfusion. Clinically adequate blood transfusions resulted in a 5 mm increase in mean left ventricular internal dimensions at end systole in those with acute blood loss and a 3 mm increase in those with chronic anaemia. None of these patients developed acute pulmonary oedema. This study provides base-line data for changes in ventricular dimension resulting from the standard medical management of patients with acute and chronic blood loss. Functional aortic valvular insufficiency was documented in some cases and pericardial effusion resolving after blood transfusion was common.

Aged↗
PubMed1981

Echocardiography in elderly patients with systolic murmurs.

Clinical examination, phonocardiography and echocardiography were performed on 49 elderly patients with systolic murmurs. Patients with mitral murmurs had increased left atrial and left ventricular diameters, increased mitral valve closure rate and excursion with a higher frequency of previous congestive cardiac failure. There was no difference in aortic root diameter or aortic valve excursion between the two groups. Patients with mitral murmurs were more likely to have an abnormal echocardiogram and abnormalities of mitral valve leaflet function were most commonly observed.

Age Factors↗
PubMed1975

Complete heart block and systemic lupus erythematosus.

An 18-year-old girl with systemic lupus erythematosus developed progressive electrocardiographic abnormalities over a period of 16 years, culminating in complete heart block with Adams-Stokes attacks. A permanent ventricular pacing system was implanted successfully.

Adams-Stokes Syndrome↗
PubMed1974

A correlative isotopic and histological study of soleal vein thrombosis.

Thirteen patients are described in whom the results of (125)I fibrinogen uptake testing in life were compared with the postmortem findings in the soleus muscle and in addition with direct radioactive counting of soleus muscle portions. The sensitivity of the (125)I fibrinogen uptake test was found to be approximately half that of direct muscle radioactive counting or histological examination. Some limitations of the technique are discussed.

Aged↗