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Biomedical subjects

T W Moir

Publications and source records attributed to T W Moir.

14 recordsLinked to original sources
PubMed1989

The bleeding severity index: validation and comparison to other methods for classifying bleeding complications of medical therapy.

Reports of bleeding complications of medical therapy should be based on valid methods of classification, but the reproducibility of existing methods has not been tested. Therefore, we prospectively studied three methods to classify the severity of bleeding: a purely subjective implicit method, a previously published explicit method using brief criteria, and the bleeding severity index, which is a new explicit method using detailed criteria about the amount, rate, and consequences of bleeding. Three physicians independently reviewed abstracts of 168 patients treated with anticoagulants. The proportion of cases classified as major bleeding varied widely when the implicit method was used (2, 14 and 39%), less when the old explicit method was used (28, 40 and 47%), and not at all when the new bleeding severity index was used (20, 20 and 20%). Intraobserver agreement was excellent for both explicit methods (kappa greater than or equal to 0.95). However, interobserver agreement was better for the bleeding severity index (kappa = 0.87) than for the old explicit method (kappa = 0.69) or the implicit method (kappa = 0.39). We conclude that the classification of bleeding complications of medical therapy depends on the method used. In comparison to older methods, the bleeding severity index is highly reproducible and should be tested more widely to determine whether it can be applied to the burgeoning clinical research in anticoagulation and thrombolysis.

Anticoagulants↗
PubMed1985

Distance running in the 1980s: cardiovascular benefits and risks.

Although within the capacity of perhaps one to two percent of highly motivated patients after myocardial infarction, long-distance and marathon running do not confer on normal subjects immunity from coronary atherosclerosis or freedom from high grades of ventricular ectopy during running and nonrunning activities. The presence of significant coronary heart disease does not preclude participation in long-distance and marathon running, provided appropriate safety precautions are taken. There is no conclusive proof that the long-term prognosis is improved by long-distance or marathon running or by increasing the intensity of training above the generally accepted level of 60 to 80 percent of VO2 max. Marathon running for coronary patients and for coronary-prone persons remains experimental and awaits further scientific evaluation employing a prospective randomized study of subjects with angiographic proof of significant coronary artery disease.

Adaptation, Physiological↗
PubMed1984

Gated magnetic resonance imaging of the normal and diseased heart.

Gated cardiac magnetic resonance (MR) images were obtained in two normal volunteers and 21 adults with a variety of cardiovascular abnormalities. The images were correlated with data from clinical examinations, electrocardiograms, and cardiac catheterization. Gated cardiac images were superior to nongated images. Combined cardiac and respiratory gated images were superior to images obtained with cardiac gating only, but acquisition time was longer. Portions of the coronary arteries were visualized in seven of 23 examinations (30%), and subacute and old myocardial infarcts were seen in five of nine patients (55%) as areas of thinned myocardium. No signal changes were observed in the patients with subacute infarctions or the patient with myocarditis. Coronary atherosclerotic lesions were not visualized in any of the patients. Normal cardiac anatomy (chambers, valves, and papillary muscles) was well visualized. Examples of aortic stenosis and atherosclerosis of the abdominal aorta are shown.

Aortic Valve Stenosis↗