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Biomedical subjects

J Fry

Publications and source records attributed to J Fry.

At least 109 records · Page 6Linked to original sources
PubMed1975

Intra-aortic balloon counterpulsation: potential for therapy in hemorrhagic shock with associated myocardial failure.

After attaching appropriate monitoring devices enabling the measurement of the slope of the left ventricular function curve, left atrial pressure, mean aortic pressure, peak left ventricular pressure, and tension time index, three groups of ten dogs were subjected to varying periods of hemorrhagic shock until a slope of their ventricular function curve was reduced to either 75% (Group I), 50% (Group II), or 25% (Group III) of their baseline value. Resuscitation was attempted in all dogs by the intravenous infusion of shed blood plus additional balanced salt solution. This infusate was administered to maintain either the mean aortic pressure within 15 mm Hg of the baseline value or a left atrial pressure of 15 mm Hg, whichever occurred forst. One half of the dogs received, in addition, intra-aortic balloon counterpulsation. All dogs not receiving counterpulsation expired within two hours. There was no apparent effect of counterpulsation on Group I animals. Three of five animals (Group II) and four of five animals (Group III) receiving counterpulsation survived to the end of the experiment with significant (p smaller than .01) improvement in the parameters monitored. The utilization of counterpulsation as an adjunct to treatment in hemorrhagic shock is suggested.

Animals↗
PubMed1975

An investigation of endocardial viability ratio in myocardial failure following prolonged hemorrhagic shock.

Previous work has documented prolonged survival in dogs subjected to hemorrhagic shock when intra-aortic balloon counter-pulsation (IABC) was instituted in the presence of a 25%-50% reduction in the slope of the left ventricular function curve. Little benefit was noted in the presence of a 75% reduction in slope. In this study, myocardial failure was created in ten dogs by varying periods of hemorrhagic shock. The Endocardial Viability Ratio (EVR) was selected as a method of assessing coronary subendocardial perfusion and was evaluated as a potential method of selecting patients with myocardial failure most likely to benefit from IABC by noting the correlation between EVR and the slope of a simultaneously constructed left ventricular function curve. A significant correlation (r equals .72, p smaller than .001) was noted. The data suggest that a major factor in myocardial failure following hemorrhagic shock is deficient subendocardial coronary perfusion. Variability in data points would make selection of patients on the basis of EVR difficult.

Animals↗
PubMed1975

Long-surviving hypertensives--a 15-year follow-up.

In a London suburban general practice 87 hypertensives have been followed up for more than 15 years. These represented one third of all those (270) aged 30-59 diagnosed as being hypertensive. Females outnumbered males by 2.5: 1. Most (85 per cent), had mild or moderate high blood pressure at first diagnosis with a diastolic blood pressure less than 120mm Hg.At assessment 15-25 years from first diagnosis, 58 (78 per cent) were still alive and of these 51 (58 per cent) were well and had no obvious ill effects; 17 (20 per cent) had complications from their high blood pressures. Deaths occurred in 19 (22 per cent) after more than 15 years of observation.I suggest that within the condition which we label as hypertension there are many in whom the condition is relatively benign and may be left untreated with hypotensives. These tend to be women rather than men, the older rather than the younger, and those with lower diastolic blood pressures.Once diagnosed, high blood pressure is not necessarily a progressive condition. In one third (30 per cent) of this group the diastolic blood pressures fell during the period of observation, in 18 per cent it remained unchanged and in 52 per cent it rose.

Adult↗
PubMed1975

Deaths and complications from hypertension.

In a long term follow-up over 25 years in a general practice the observed courses of complications and deaths in a group of 704 hypertensives were recorded and compared with those that occurred in the practice as a whole over the same period. The risks to the hypertensives were calculated as ratios of the observed: expected (O/E) complications and mortalities.Of the total number of complications and deaths (418), one half were cardiovascular and one-third were strokes.The O/E rates for coronary artery diseases as a whole showed no extra risks for the hypertensives, but the risks for young female hypertensives were appreciably higher. The O/E rates were nearly three times higher for females. The risks of hypertensives suffering from coronary artery diseases fell with age in both sexes.The observed rates for strokes were nearly four times greater than those expected. The O/E rates were similar in males and females. There was a decline with age.An unexpected finding was the higher O/E rate for dementia in elderly female hypertensives.The findings confirm the higher risks of complications and deaths for hypertensives, but within the whole spectrum of hypertension are some groups who are more vulnerable than others. These are males and those under 60 years of age. These vulnerables probably account for less than one half of all hypertensives diagnosed. It is suggested that a much more discriminating policy for the management of hypertension is accepted in order to make diagnosis and treatment of those hypertensives who really need intensive care practical, feasible, and possible.

Adult↗