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Biomedical subjects

H Newman

Publications and source records attributed to H Newman.

At least 37 records · Page 2Linked to original sources
PubMed1986

Prediction of multivessel coronary artery disease and prognosis early after acute myocardial infarction by exercise electrocardiography and thallium-201 myocardial perfusion scanning.

Exercise electrocardiography and thallium scanning were performed a mean of 24 days after uncomplicated acute myocardial infarction in 103 patients, aged 36 to 60 years, who also underwent coronary angiography. The purpose of the study was to determine the ability of the noninvasive tests to predict multivessel coronary artery disease (CAD) and prognosis. Patients were followed up to document medical complications (incidence 12%: 3 deaths, 1 resuscitated cardiac arrest, 4 recurrent infarctions, 4 admissions with unstable angina) and combined events (medical events or bypass surgery, incidence 23%). The sensitivity, specificity and predictive accuracy for predicting multivessel CAD were 64%, 77% and 64% for a positive exercise electrocardiographic (ECG) response, 64%, 88% and 80% for a remote thallium defect, and 42%, 96% and 88% for a combination of the 2 tests. With 2 tests yielding negative findings the probability of multivessel CAD was 13%. No variable (positive exercise ECG response, remote thallium defect and presence of multivessel CAD) predicted medical events, although there were nonsignificant trends to more events in patients with any of those findings. The relative risk of combined events was 2.5 (p less than 0.05) for a positive exercise ECG response; 1.8 (NS) for a remote thallium defect; 2.6 (p less than 0.05) for multivessel CAD; and 3.1 (p less than 0.025) for both positive ECG response and remote defect. A combination of exercise electrocardiography and thallium scanning early after acute myocardial infarction helps to identify subsets of patients with high and low probabilities of multivessel CAD and combined medical or surgical events.

Adult↗
PubMed1986

Association of embolic stroke in pregnancy with the lupus anticoagulant. A case report.

Recently the association of recurrent spontaneous abortions and intrauterine fetal death was linked to the lupus anticoagulant (LA). LA is an immunoglobulin directed against phospholipid, causing characteristic changes in coagulation tests, and is associated with an increased risk of thrombosis. We treated a pregnant woman who presented with an embolic stroke and laboratory evidence of LA.

Adult↗
PubMed1985

Relation of left ventricular function and prognosis in hypertrophic cardiomyopathy: an angiographic study.

Left ventricular cineangiograms performed at the time of diagnosis in 88 patients with hypertrophic cardiomyopathy were digitized to evaluate the relation of left ventricular function and prognosis in hypertrophic cardiomyopathy. Eleven patients died suddenly after a mean follow-up period of 7.5 +/- 7 years, 10 patients died of congestive heart failure or after cardiac surgery and 67 were alive after a mean follow-up period of 8.6 +/- 4 years. Measurements of left ventricular volume, ejection fraction, peak rate of ejection and filling and time to peak rate of ejection and filling were derived from curves of ventricular volume and its rate of change during the cardiac cycle. Patients who died suddenly had a lower peak rate of ventricular ejection (stroke volume-normalized peak ejection rate 5.41 +/- 0.69 versus 6.24 +/- 1.33 s-1; p = 0.006) and lower peak rate of ventricular filling (end-diastolic volume-normalized peak filling rate 4.02 +/- 0.94 versus 4.88 +/- 1.53 s-1; p = 0.02) and stroke volume-normalized peak filling rate (4.75 +/- 1.08 versus 5.82 +/- 1.70 s-1; p = 0.01) compared with survivors. Stepwise regression analysis revealed that sudden death was best predicted by the combination of increased end-diastolic volume, small end-systolic volume and low peak filling rate (predictive accuracy 32%, false negative 18% and false positive 28%). The addition of clinical features and hemodynamic measurements to the analysis improved predictive accuracy to 43% (false negative 18% and false positive 18%). Ambulatory electrocardiographic monitoring performed in 57 of the 88 patients 1 month to 17 years (median 8 years) after diagnosis revealed ventricular tachycardia in 14 (25%). Of these, 10 who survived had hyperkinetic systolic function at diagnosis, whereas the 4 who died suddenly had impaired systolic function (end-diastolic volume-normalized peak ejection rate 5.93 +/- 1.2 versus 4.01 +/- 1.2 s-1, respectively; p = 0.04). In hypertrophic cardiomyopathy, ventricular tachycardia is a sensitive but nonspecific marker of adults who are at risk of sudden death. Impaired systolic function may be an important determinant of which patients with ventricular tachycardia die suddenly. This study shows that indexes of ventricular function contribute to the identification of patients at particular risk of sudden death. However, the predictive power of the clinical features and hemodynamic and angiographic measurements that could be assessed was poor.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗
PubMed1984

Subclavian-axillary vein thrombosis: successful treatment with streptokinase.

Proximal vein thrombosis has been associated with residual disability from the postphlebetic syndrome in patients receiving symptomatic therapy or heparin and sodium warfarin. This paper describes a man with painless swelling of the right arm secondary to subclavian-axillary vein thrombosis that was successfully treated with streptokinase and conventional anticoagulant therapy.

Adult↗
PubMed1983

Treatment of cancer of the cervix with a high-dose-rate afterloading machine (the Cathetron).

Two hundred and ninety-one patients with invasive carcinoma of the cervix uteri were treated by a combination of external beam therapy (telecobalt or 4 Mv Linear accelerator) and a high dose-rate afterloading intracavitary apparatus (the Cathetron). All patients have been followed for a minimum of 3 1/2 years. The five year survival rates are: all patients 55%; Stage I, 81%; Stage IIA, 74%; Stage IIB, 40%; Stage III, 27%. Death was directly attributed to treatment in five patients. We found a serious complication rate of 3% for all patients treated, the major problem being radiation ileitis. It is concluded that high dose-rate treatment offers comparable results to conventional radium therapy; the choice between high and lose dose-rate afterloading systems depends on the number of patients needing treatment and associated economic factors rather than any intrinsic radiobiological advantage of either system.

Adenocarcinoma↗
PubMed1983

Ilio-psoas abscess in Crohn's disease.

We encountered 12 patients with psoas abscess in a two-year period. Of these, four were due to Crohn's disease making this the most important single cause of such abscesses in our series. Psoas abscess may be the presenting complaint in Crohn's disease and it should be considered as a possible cause of any psoas abscess from which enteric organisms are cultured.

Adult↗
PubMed1981

Reproduction in rabbits after excision of the oviductal isthmus, ampullary-isthmic junction, and uteroisthmic junction.

The effect of total deletion of the isthmus, including the ampullary-isthmic junction and the uteroisthmic junction, upon reproduction was determined in 21 rabbits. None became pregnant on the side lacking isthmus, whereas all became pregnant on the intact control side. Eight does were studied using in vivo and in vitro techniques at 18 to 20, 64 to 65, and 136 to 137 hours after mating. Spermatozoa fertilized the ova, with evidence of polyspermy. However, the modified oviduct did not transport fertilized ova into the uterus at the normal time. Furthermore, degeneration was noted from the morula stage onwards. We conclude that the rabbit ova can neither develop normally past the morula stage nor enter the uterus at the normal time in a recognizable form in the total absence of isthmus, and infertility results.

Animals↗
PubMed1980

Psychiatric illness in family practice.

One hundred twenty patients from each of 6 family practices were surveyed to determine the prevalence of symptom-based psychiatric illness (emotional distress) in family practice. Assessments of presence or absence of emotional distress and the severity of this distress were made using ratings made by the treating physician and by the patient. Nineteen percent of the surveyed patients were designated by their physicians as having "high distress," and 21% by the patient-completed abbreviated Hopkins Symptom Checklist (HSCL-25). High concordance (86.7%) existed between the "case" assessment by the physician and the patient's own rating of distress. For the majority of "high distress" patients, pharmacotherapy was considered the treatment of choice by physicians.

Adult↗