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Biomedical subjects

I C Gilchrist

Publications and source records attributed to I C Gilchrist.

29 records · Page 2Linked to original sources
PubMed1990

Angioplasty of occluded coronary arteries: use of thin shaft balloon over-the-wire system without pre-dilatation.

A retrospective review was done on 13 consecutive patients who underwent PTCA of totally occluded coronary arteries using a recently released thin shaft balloon over-the-wire angioplasty system. Balloon size was determined by the closest fit to the arterial size and used without predilatation techniques. This technique was initially successful in 12 patients with only 2 clinically insignificant episodes of distal embolization and one probable early reclosure. Using thin shaft angioplasty systems, balloon dilatation of totally occluded coronary arteries can be done safely with a single balloon in many cases resulting in simplified procedures and economic benefits.

Angioplasty, Balloon, Coronary↗
PubMed1988

Chronic bundle branch block and use of temporary transvenous pacemakers during coronary arteriography.

A retrospective analysis of 217 consecutive patients with chronic bundle branch blocks undergoing cardiac catheterization was done to evaluate the need for temporary transvenous pacing during coronary arteriography. In patients without temporary right ventricular pacemakers (n = 185), only one episode of high-grade atrioventricular block occurred during coronary arteriography which required the urgent use of temporary pacing. All other bradyarrhythmias, including five episodes of transient asystole (greater than 3-sec pause) and four episodes of atrioventricular block (second degree or higher) were successfully managed without pacemaker utilization. Patients with prophylactic right ventricular pacemakers (n = 32) had a greater prevalence of ventricular fibrillation than those without pacing electrodes located in the right ventricle (2% vs. 9% respectively; P less than 0.05). These findings suggest that routing prophylactic pacemaker insertion during coronary arteriography in patients with chronic bundle branch block is not warranted and may place the patient at risk for developing iatrogenic ventricular arrhythmias.

Adult↗
PubMed1987

Temporary pacemaker use during coronary arteriography.

The risk of life-threatening ventricular arrhythmias complicating coronary angiography is reportedly increased in patients in whom temporary righ ventricular pacemakers are used. Placement of the temporary pacing electrode in the right atrium or vena cava during angiography theoretically removes from the vulnerable ventricle a source of mechanically or electrically induced ventricular arrhythmias. This hypothesis was evaluated in 7,648 consecutive patients who underwent cardiac catheterization with selective coronary angiography, including 103 with life-threatening ventricular arrhythmic complications. The prevalence of ventricular arrhythmias was 6.4 times greater in patients with temporary pacemakers than in those without (7% vs 1.1%, respectively, p less than 0.001). Analysis of 369 cardiac catheterizations concurrently using temporary pacemakers revealed a greater than 4-fold decrease in the frequency of ventricular arrhythmias when the pacing electrodes were located in the right atrium or vena cava rather than the right ventricle (2% vs 9%, respectively, p less than 0.01). No significant difference in indications for temporary pacing could be distinguished between the groups based on location of the pacing electrode or occurrence of ventricular arrhythmias. These findings confirm that there is an increased risk of ionic contrast agent-induced ventricular arrhythmias in patients with chronic underlying conduction disturbances undergoing coronary angiography with concurrent right ventricular temporary pacemakers. This risk can be significantly decreased by placing the pacing electrode in the right atrium or vena cava.

Adult↗
PubMed1983

Psychological aspects of acute low back pain in general practice.

A prospective controlled study of acute low back pain in general practice was carried out. The presence of psychiatric illness was measured by use of the general health questionnaire (GHQ), by clinical assessment, and personality factors by use of the Eysenck personality inventory (EPI). It was found that overall the amount of psychiatric illness did not differ between patients with back pain and their controls at the time of presentation, although there was a higher prevalence of previous psychiatric illness in the back-pain group. The only difference in the personality factors measured was a higher degree of extraversion in the back-pain patients.

Acute Disease↗
PubMed1983

Different groups of patients with low back pain.

A method of distinguishing between three categories of patients with low back pain as seen in general practice is described. It was found that the main discriminatory factors were based on restricted movement and on a past history of psychiatric illness. The experimental findings are discussed and compared with previous published works.

Back Pain↗
PubMed1978

Social work in general practice.

A questionnaire seeking details of working arrangements and problems encountered was circulated to social workers working in general practice.THE MAIN DIFFICULTIES WERE: insufficient preparation for the scheme, poor communication between general practitioners and social workers, and the inadequate provision of facilities for social workers in practice premises.Most of the respondents had not experienced big difficulties. Two thirds had enjoyed a rewarding professional experience, which is a testimonial to interdisciplinary co-operation.

Family Practice↗
PubMed1976

Psychiatric and social factors related to low-back pain in general practice.

In a study of 1499 patients over six years in a general practice, an association was found between a history of low-back pain and a history of psychological illness, in several demographical groups. The association was strongest in patients of both sexes, aged 35--44, and in women aged 55--74. Patients with a history of low-back pain were more likely to have had a diagnosis of 'anxiety' than non-low-back-pain patients, whereas there was no significant difference in the incidence of 'depression' between those with, and those without, low-back pain.

Adolescent↗
PubMed1973

Patient delay before treatment of myocardial infarction.

Fifty patients in hospital with a definite recent myocardial infarction were interviewed, particular attention being paid to the delay before medical attention was sought. No evidence was found to associate delay with age, sex, or social class. The delay was longer outside normal working hours, and in some patients this seemed to be due to inhibition from disturbing their general practitioner. It is suggested that doctors should ensure that patients at high risk of sustaining a myocardial infarction should not be inhibited from seeking attention quickly if the need arises.

Adult↗
PubMed1971

Factors affecting admission to a coronary care unit.

Of 103 patients with suspected myocardial infarction admitted to an intensive care unit in a general hospital half were admitted within four and a half hours of the onset of symptoms. In general, patients who attended the casualty department were under intensive care sooner than patients who sought attention from their general practitioner before admission. Patients who were seen by a locum from the emergency treatment service at night or weekends were more likely to remain at home until seen the next day by their own general practitioner, compared with patients seen by their own general practitioner initially.

Coronary Care Units↗