Search PubMed⌕ Search

Biomedical subjects

G C Oliver

Publications and source records attributed to G C Oliver.

At least 37 records · Page 2Linked to original sources
PubMed1983

Long-term prognosis after first Q-wave (transmural) or non-Q-wave (nontransmural) myocardial infarction: analysis of 593 patients.

Follow-up results in 593 patients less than or equal to 7 years (mean 4.7) after hospital discharge for their first myocardial infarction (MI) are presented. Patients were grouped according to the presence or absence of Q waves on electrocardiograms after the MI and by peak serum glutamic oxalacetic transaminase (SGOT) level during hospitalization. Cardiac mortality varied. Patients with Q-wave infarcts and an SGOT level less than or equal to 240 IU/liter had a cardiac mortality of 3.1% per year, whereas patients with Q-wave MI and an SGOT level greater than 240 IU/liter had an 11% 6-month mortality and a 3.8% per year cardiac mortality thereafter. However, patients with non-Q-wave (nontransmural) MI had a excellent survival rate for 2 years (96.8%) which continued in patients aged less than or equal to 60 years thereafter. However, patients with non-Q-wave infarcts aged greater than 60 years had a 12% per year cardiac mortality in the third post-MI year and an additional 12% died each year thereafter. Early mortality was related to enzyme level, whereas late mortality was a function of type (Q-wave or non-Q-wave) and age.

Aged↗
PubMed1983

Surgical diseases of the breast during pregnancy.

Physicians caring for women with diseases of the breast are well aware of the time lost before many patients consult their physicians. Nowhere is this more apparent than when a breast mass is associated with gestation or lactation. Enlargement of the breast tends to obscure parenchymal masses. Those that are found are too readily attributed to normal hypertrophy, abscess, or resolving fibrocystic disease. In this review we have attempted to focus on the earlier diagnosis and treatment of breast masses in pregnancy. Prompt needle aspiration will elucidate the solid or cystic nature of a mass. A simple cyst or a galactocele can be diagnosed by the fluid obtained. Solid lesions can be further investigated by fine-needle aspiration for cytologic study. Cytologically equivocal lesions should be subjected to excisional biopsy using local anesthesia. Cancerous lesions occurring during pregnancy should be treated promptly by mastectomy. The outlook for these patients, if treated before metastases occur, is comparable to that for nonpregnant patients. Pregnancy need not be terminated unless disseminated cancer is present and chemotherapy is necessary on an urgent basis.

Adenoma↗
PubMed1982

Effect of infarct location on the in-hospital prognosis of patients with first transmural myocardial infarction.

We studied the in-hospital prognosis of 1105 patients who had their first transmural myocardial infarction; 611 patients (55.3%) had anterior myocardial infarction (AMI) and 494 (44.7%) had inferior myocardial infarction (IMI). Patients with IMI had a significantly lower in-hospital mortality rate (9.1% vs 15.6%, p = 0.0014) and significantly lower prevalences of congestive heart failure (39.4% vs 47.6%, p = 0.0066), cardiogenic shock ( 8.7% vs 12.6%, p = 0.0384) and conduction defects (left anterior hemiblock, right bundle branch block and intraventricular conduction defect). The patients with AMI had significantly higher peak enzyme levels, and a greater percentage of them (40.1% vs 25.9%) had SGOT greater than 240 IU/l, whereas more patients with IMI (34.6% vs 27.8%) had SGOT less than 120 IU/l (p = 0.0001). When the parallel subgroups were compared according to the peak SGOT levels (less than 120, 120-240, and greater than 240 IU/l, the differences in the mortality and morbidity between the two infarct locations diminished. However, patients with AMI still had a less favorable outcome. Logistic regression analysis demonstrated that both the peak enzyme level and the infarct location had an independent influence on the in-hospital prognosis of patients with first transmural infarction.

Aged↗
PubMed1981

Influence of recording scale on determination of left ventricular end-diastolic pressure.

Left ventricular (LV) pressure waveforms for 20 beats, originally recorded at 200 scale (200 torr/10 cm) were rescaled by a computer system to represent the identical beats recorded at 40 scale (40 torr/10 cm). Both the original and the rescaled beats were independently evaluated by eight cardiologists who were unaware of the nature of the manipulated data. For each beat the average left ventricular end-diastolic pressure (LVEDP) identified by the eight cardiologists was higher when analyzed on the 200 scale, with an average difference of 2.8 torr (P Less Than 0.001). This scale-dependence of pressure analysis has implications for the development of automated pressure analysis algorithms and for physician review of computer-determined LVEDP data points.

Blood Pressure↗
PubMed1981

Cardiac arrhythmias in end-stage renal disease.

In 16 patients with end-stage renal disease (ESRD), 24-hour electrocardiographic recordings showed an incidence of supraventricular and ventricular arrhythmias similar to that in patients who had had myocardial infarction and in low-risk subjects. Eight patients (50%) with ESRD had supraventricular complexes. This incidence was significantly higher than that after myocardial infarction (P < .001). Fifteen ESRD patients (94%) had premature ventricular complexes (PVCs), including nine (56%) with complex PVCs (multiform PVCs, couplets, or runs). The incidence of PVCs as well as complex PVCs in patients with ESRD was comparable to that of the patients who had had myocardial infarction but was significantly higher than that found in low-risk subjects (P less than .005 for PVCs and P less than .05 for complex PVCs). The high incidence of complex PVCs in patients with ESRD may predispose them to increased cardiovascular death, and further investigation of this finding is indicated.

Adolescent↗
PubMed1981

Left ventricular function in end-stage renal disease: echocardiographic classification.

We used echocardiography (ECHO) to detect pericardial effusions and assess left ventricular (LV) function in 39 patients with end-stage renal disease (ESRD). Pericardial effusions were present in 24 patients (62%). Thirty-one patients (79%) had concentric hypertrophy and 20 patients (51%) had decreased LV compliance. The majority of patients with concentric hypertrophy and decreased LV compliance had normal LV internal dimensions and contractility. Six patients (15%) had ECHO results compatible with congestive cardiomyopathy. An echocardiographic distinction between congestive heart failure, decreased LV compliance, and salt and water overload in ESRD has allowed an appropriate therapeutic decision as to whether to administer cardiac glycosides or increase ultrafiltration as a treatment for pulmonary congestion. ECHO is a safe, convenient, and noninvasive method of assessing serial LV function, and it can be used to document progressive deterioration of LV function in ESRD.

Adolescent↗
PubMed1981

The effectiveness of antiarrhythmic agents on early-cycle premature ventricular complexes.

Twelve patients completed a double-blind, crossover antiarrhythmic drug trial in which 300 mg of quinidine, 500 mg of procainamide, 100 mg of phenytoin, or placebo was given four times daily on subsequent weeks. Analysis of 24-hour Holter tapes with a computerized analysis system (Argus/H) permitted accurate counting of premature ventricular complexes (PVCs) subclassified according to coupling interval. No antiarrhythmic agent demonstrated a significant overall reduction in the number of PVCs, but both quinidine and procainamide showed a statistically significant (p less than 0.05) reduction of PVCs with coupling intervals less than 400 msec. This effect was noted both in isolated PVCs (quinidine only) and in PVCs that were part of a couplet or run (both drugs). These findings demonstrate that clinically important effects of procainamide and quinidine can occur in the absence of an overall reduction in the number of PVCs.

Aged↗
PubMed1980

In-hospital prognosis of patients with first nontransmural and transmural infarctions.

We studied the in-hospital mortality and morbidity of 745 patients who had suffered a first myocardial infarction. One hundred twenty-four patients (16.6%) had nontransmural infarction and 621 (83.4%) had transmural infarction. Both groups of patients were similar in the distribution of age, sex, and coronary risk factors. Patients with nontransmural infarction had a significantly lower mortality (3% vs 11%, p less than 0.01) and a lower prevalence of premature ventricular complexes (81% vs 88%, p less than 0.05). The patients with transmural infarction were distributed evenly among the three subgroups with peak SGOT levels less than 120 units, 120-240 units and more than 240 units (31%, 34% and 35%, respectively), while most patients with nontransmural infarction (60%) had peak SGOT levels less than 120 units (p less than 0.0001). When the in-hospital mortality and morbidity were compared between the parallel subgroups, the prognosis of patients with the two types of infarctions was similar. This study shows that the peak SGOT level is more important than the type of infarction in determining the acute mortality and morbidity of first myocardial infarction.

Acute Disease↗
PubMed1980

Computer recognition of cardiac arrhythmias.

The current status of systems for computer recognition of cardiac arrhythmias for routine clinical electrocardiography and for rhythm monitoring has been presented. The goal is to approach the pattern recognition capabilities of the human observer and to add the advantages of the computational prowess and indefatigability of the digital computer. The accuracy of the methods obviously depends on the population studied; excellent results in screening of normals contrast with poorer achievement in patients with complex arrhythmias. The other factors involved include high quality (noise-free) ECG recordings, parameter measurement accuracy, the degree of program sophistication, and the role of human intervention in the various systems. The future looks extremely promising for both computer applications for ECG arrhythmia analysis. The important factors to be considered have been presented at the Tenth Bethesda Conference on "Optimal Electrocardiography" in April 1977. The establishment of "gold standard" tapes for both routine and monitored ECG recordings will provide vital data for evaluation of all systems. There is an ongoing, constant upgrading of recording and computer equipment, data transmission methods, and program sophistication together with continual cost reduction. With this rapid progress, computer analysis of cardiac arrhythmias can be expected to achieve routine application in our cardiologic diagnostic armamentarium.

Arrhythmias, Cardiac↗
PubMed1979

Epicardial pacemaker complicated by cardiac tamponade and constrictive pericarditis.

Following insertion of an epicardial pacemaker, our patient developed cardiac tamponade complicated by subacute constrictive pericarditis. Echocardiographic findings and intracardiac pressures were typical of constrictive pericarditis, which was confirmed at surgery. Although rare, these unusual complications should be considered in patients who develop evidence of reduced cardiac output following either transvenous or epicardial electrode placement.

Aged↗
PubMed1977

Continued incorporation of circulating radiolabeled fibrinogen into preformed coronary artery thrombi.

This study measured the growth over time of experimental coronary artery (CA) thrombi by radiolabeled fibrinogen uptake. 125I-fibrinogen was injected into dogs and 24 hours later CA thrombi were induced by electrical current. Twenty-four hours after CA thrombus induction, 131I-albumin (group A) or 131I-fibrinogen (group B) was injected. At 48 hours after thrombi induction, the thrombi were removed, divided into segments, and their radioactivity measured. The 131I-fibrinogen in the group B thrombi was significantly greater than the 131I-albumin in group A thrombi (P less than 0.001). In further studies, the 131I-fibrinogen was given 48 and 72 hours post CA thrombus formation. Significant 131I was also found in these CA thrombi. 125I-fibrinogen and 131I-fibrinogen incorporation occurred in virtually all segments of the thrombi. The results suggest 1) CA thrombi growth continues for at least 72 hours after initial formation; 2) the presence of 131I in the thrombi was due to gradual fibrin deposition throughout the thrombus.

Albumins↗