ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1980.tb04070.x

出版商:Blackwell Publishing Ltd    

年代:1980

数据来源: WILEY

摘要:

Summary:Over an 18 month period, 19 patients were referred for assessment of excessive daytime sleepiness and/or loud snoring. Respiratory studies during sleep were performed in 14 of these patients with additional features such as disturbed sleep, observed apnoea during sleep, morning headache, mental and personality changes, hypertension and cardiac failure.Nocturnal respiratory studies undertaken for periods of 4–8 hours confirmed a diagnosis of the Sleep Apnoea Syndrome in eight patients. In these patients apnoeas, lasting from 30–144 seconds, occurred frequently during sleep (from 35–291 episodes per patient).In one severely affected patient, tracheostomy abolished all symptoms. The use of conservative therapy such as weight loss, protriptyline or a neck collar, highlighted the inadequacies of current medical treatment. Awareness of the symptom complex and potential complications of the Sleep Apnoea Syndrome is important because the diagnosis may easily be missed if the patient presents with one or two isolated compl

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1980.tb04071.x

出版商:Blackwell Publishing Ltd    

年代:1980

数据来源: WILEY

摘要:

Summary:Fifty‐five patients with recent acute myocardial infarction entered a single‐blind cross‐over trial to assess the effect of oral practolol 200 mg twice daily on the incidence and nature of ventricular arrhythmias in the first year following myocardial infarction. Patients had 24‐hour Hotter electrocardiogram tape monitoring at two weeks following infarction and at three‐monthly intervals for one year.Twenty‐six patients completed the full year of the trial with 12% of tape recordings technically unsatisfactory. A total of 46 periods of comparison of the action of practolol versus placebo therapy were available in thirty patients.Whilst receiving the selective beta adrenergic blocking agent, practolol, there was a significant reduction in the percentage of studied hours during which salvos of ventricular premature beats occurred (P<0·025), however the percentage of patients in whom salvos were recorded was unchanged. The incidence of all other ventricular arrhythmias was not reduced in the practolol group. When the effect of practolol was related to the site of infarction, anterior or inferior, there was no significant reduction in the incidence of ventricular

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1980.tb04072.x

出版商:Blackwell Publishing Ltd    

年代:1980

数据来源: WILEY

摘要:

Summary:Between November 1977 and September 1978, early post‐operative angiography was performed in 50 of 53 consecutive patients undergoing coronary artery bypass surgery. An average of 2–4 grafts per patient were applied. The overall patency rate was 82% and was not affected by the degree of proximal native vessel stenosis. Grafts to circumflex marginal vessels had a significantly lower (P<0·05) patency rate (72%) than grafts to the left anterior descending (84%) and its diagonal branches (85%), or to the right coronary artery (90%). Ten single grafts were applied and all were patent. Forty‐nine of the 50 patients had at least one patent graft. Fifty‐three per cent of the grafts were considered of excellent quality and 25% patent but of fair quality only. There was a 100% patency rate for vessels of 2 mm diameter or more, which is significantly better (P<0·01) than for vessels of 1–2 mm diameter (78%) or for vessels of less than 1 mm diameter (50%). There was a suggestion of a lower patency rate (74%) for vessels with evidence of distal disease, compared with vessels without such disease (85%). An assessment of the overall quality of the recipient vessel was made, taking both diameter and disease into account. This showed improved results for better quality vessels in terms of graft patency (P<0·1) and graft qual

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1980.tb04073.x

出版商:Blackwell Publishing Ltd    

年代:1980

数据来源: WILEY

摘要:

Summary:The response of plasma renin activity (PRA) to frusemide, 40 mg given intravenously, was examined before and after oral propranolol 160 mg daily for seven days in normal and hypertensive subjects. Although basal PRA was reduced in many cases, the increase following frusemide was essentially unaltered by propranolol therapy. Evidence is presented that adequate beta adrenoceptor blockade was attained in these studies. Increasing the dose of propranolol to 240 mg daily for seven days in two subjects did not alter renin responsiveness to frusemide. Stimulation of renin release by oral frusemide, examined in one subject, was also unaltered by propranolol therapy. These findings indicate that enhancement of renin activity associated with diuretic use may not be prevented by concurrent propranolol administration. Limitation of the hypotensive action of combined beta blocker‐diuretic therapy can therefore be expected. The fact that the renin stimulating effect of frusemide is preserved during beta blockade indicates that this procedure can be used in the investigation of hypertension even in those patients in whom discontinuation of beta blocking treatment may be undesirabl

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1980.tb04074.x

出版商:Blackwell Publishing Ltd    

年代:1980

数据来源: WILEY

摘要:

Summary:During a prospective six year study from 1972–1978 there were 894 admissions to a haematemesis and melaena unit. In 162 admissions bleeding was due to acute gastric ulceration, an incidence of 18%. The group comprised 157 patients, five patients being admitted on two occasions. There were 12 deaths (7%), seven after surgery and five in conservatively treated patients. A significant fall in incidence of admissions was noted in the final two year period of study. The reason for this is unknown as no other cause of haematemesis and melaena showed a similar fall in incidence. In addition over this two year period patients with acute ulceration followed a more benign course and required surgery less ofte

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1980.tb04075.x

出版商:Blackwell Publishing Ltd    

年代:1980

数据来源: WILEY

摘要:

Summary:Two‐hundred‐and‐six cases of gastric carcinoma were analysed for survival on the basis of their clinical, endoscopic and operative findings. An attempt has been made to identify prognostic factors and the role of endoscopy. It is concluded that too much radical surgery is being performed in patients who can be recognised preoperatively as having obviously advanced di

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1980.tb04076.x

出版商:Blackwell Publishing Ltd    

年代:1980

数据来源: WILEY

摘要:

Summary:A computer‐based system for storing items of medical record data including a complete coded list of diagnoses was established in 1971 for all patients admitted to a research‐oriented medical ward. An analysis was made to assess the usefulness of such an electronically‐stored data base from the stand‐point of Unit activity, disease correlations, stability of diagnostic criteria, completeness of diagnosis lists and accuracy of coding. Over six years, 1972–77, there were 3569 admissions of which 1679 were first admissions. The most frequently made principal diagnoses were cerebrovascular accident (8%), myocardial infarction (5·4%), ischaemic heart disease (2·9%), rheumatoid arthritis (2%), duodenal ulcer (2%) and systemic lupus erythematosus (1·9%); the 33 most frequent principal diagnoses accounted for only 45% of all principal diagnoses made. The duration of stay (mean 16 days) was shown to depend on principal diagnosis but not significantly on age. Variability in annual incidence was significant for 24% of diagnoses; for some diagnoses this was readily explainable by extraneous causes, but for others it suggested an “instability” of criteria for that diagnosis. The probability of a minor diagnosis being “overlooked”, using Dupuytren's contracture as an example, was shown to be high (50%). The rate of miscoding a diagnosis was 5%. This study, despite its illustration of the “softness' of diagnosis making in routine hospital ward practice, illustrates the potential of processing hospital diag

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1980.tb04077.x

出版商:Blackwell Publishing Ltd    

年代:1980

数据来源: WILEY

摘要:

Summary:In search for a practical solution to analyse a large quantity of medical information, rheumatic disease data base system (RDDS) is described. Details of data configuration, data entry and retrieval are discussed in some detail. The system incorporates a range of commonly used statistical tests and provisions for more advanced data analysis are made. Additional facilities include provisions for a variety of printed reports, back up facilities and a word processor. The ease of system operation and flexibility are emphasised. Technical support requirements are minimal even when new applications are being developed. The system is fully operational at present and can be implemented on a number of computer systems.

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1980.tb04078.x

出版商:Blackwell Publishing Ltd    

年代:1980

数据来源: WILEY

摘要:

Summary:A patient with Staphylococcus aureus endocarditis is reported whose echocardiogram closely resembled that found in left atrial myxoma. Because of severe mitral incompetence, the valve was replaced using cardiopulmonary bypass and at operation a large 3 cm friable vegetation was found attached to the posterior leaflet of the mitral valve. Histological examination showed changes typical of bacterial endocarditis with no evidence of myxoma.

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1980.tb04079.x

出版商:Blackwell Publishing Ltd    

年代:1980

数据来源: WILEY