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Biomedical subjects

J Lindsay

Publications and source records attributed to J Lindsay.

At least 163 records · Page 9Linked to original sources
PubMed1982

Radionuclide evaluation of the interventricular septum following coronary artery bypass surgery.

The cases of 25 consecutive patients who had undergone radionuclide ventriculography both before and after coronary artery bypass surgery and who had had normal septal motion before surgery were reviewed. Abnormal septal motion was present in 22 patients (88%) postoperatively. In contrast, a new motion abnormality appeared following surgery in the apical segments of only 5 of 21 patients (24%) and in the lateral segments of 1 of 22 (5%) patients. All patients improved clinically following surgery, and only two had evidence of intraoperative myocardial infarction. Postoperatively, thallium imaging revealed normal septal perfusion in all six patients who underwent this examination. Thus, it appears that ischemic injury does not always account for this phenomenon, which is a potential source of confusion in patients after coronary bypass operations. It is concluded that radionuclide ventriculography identifies the same aberration of ventricular septal motion that is seen during echocardiographic examination of patients who have undergone surgery.

Adult↗
PubMed1982

Cardiac conduction abnormalities in Reiter's syndrome.

Reiter's syndrome was found in three men who presented with cardiac conduction disturbances. In two patients, Reiter's syndrome had been present for more than 30 years and had been previously unrecognized. These patients included a 67 year old man with complete heart block of 13 years' duration, and his son, who had left bundle branch block and chronic generalized cardiomyopathy. A chart review of 19 other patients with Reiter's syndrome who were seen at this institution disclosed five patients with conduction abnormalities. Transient first-degree heart block was the most common disturbance detected and was usually associated with active Reiter's syndrome. Some conduction abnormalities appeared after a long latent period at a time when other manifestations of Reiter's syndrome were inactive. An association with this disorder was therefore not obvious. In all five patients with Reiter's syndrome and conduction disturbances, testing for B27 antigen gave positive results. Both clinical and histopathologic changes in the heart in Reiter's syndrome are analogous to those in ankylosing spondylitis, also associated with B27 antigen. We suggest that the heart, like the joints and iris, may be a target organ for B27-associated disease by a mechanism that remains to be defined.

Adolescent↗
PubMed1980

The radionuclide cardiac ventriculogram. Evaluation of results in twelve hundred consecutive patients.

Coronary artery disease represents one of the most prevalent and serious diseases in the western world. In consequence, there is considerable need for a reliable method for its diagnosis. Until now the best available laboratory methods were the EKG treadmill test and arteriography. The former suffers from the disadvantages of suboptimal sensitivity and specificity, while the latter is both expensive and invasive. The recent introduction of the nuclear cardiac ventriculogram offers new hope for the non-invasive diagnosis of this condition. Based on an experience of more than two thousand patient studies, we consider that this procedure represents a significant advance in the ability to distinguish between the normal and abnormal left ventricle.

Adult↗
PubMed1980

The usefulness of radionuclide ventriculography for the identification and assessment of patients with coronary heart disease.

To assess the usefulness of radionuclide angiography for the identification and evaluation of patients with coronary heart disease, we analyzed 100 consecutive patients who had undergone that examination and coronary arteriography. Regional wall motion abnormality during exercise was detected in 65 of 76 (86%) patients with occlusive coronary disease and in one of 11 (9%) with normal coronary arteries and normal left ventriculograms. The changes in the left ventricular ejection fraction in response to exercise were not helpful for the identification of individual patients with coronary disease, since changes were often small and within the error of the technique. Substantial decline of the ejection fraction during exercise indicated multivessel disease or severe proximal left anterior descending artery occlusion.

Adult↗
PubMed1980

Long-term outcome in children with temporal lobe seizures. IV: Genetic factors, febrile convulsions and the remission of seizures.

Three groups of children are considered: 100 children with temporal lobe epilepsy, 59 of whom had also had febrile convulsions; their 214 sibs; and an unselected coeval sample of 438 children with febrile convulsions. When the family history is positive for seizures, the adverse factors described in previous papers in this series do not discriminate between those who remit their epilepsy and those who do not. Interactions between age of onset, family history and outcome are displayed. In the absence of an affected relative, none of 26 children with an onset below four years remitted. Six had their first seizure at a later age, of whom three remitted. In the presence of a first-degree affected relative, 10 out of 19 remitted: age of onset was cut off at 2 years 9 months. Eight children had second-degree affected relatives; there were four remissions, all with onset after three years. The authors compared the proportion of simple benign febrile convulsions in 438 unselected children who had fits with fever, with the same ration in the probands' affected siblings. The two ratios were the same. They conclude that one gene promoting febrile seizures was common to both groups. The siblings of those probands who remitted their seizures had a 38 per cent risk of seizures: the siblings of non-remitters had an 11 per cent risk. A new genetic theory is proposed to account for these data. Practical considerations include genetic advice, the necessity of weaning some patients from anticonvulsants, and early discrimination of those likely to need neurosurgical relief of their epilepsy.

Adolescent↗
PubMed1980

Cancer incidence and mortality in relation to occupation in 700,000 members of the Canadian labour force.

The mortality and cancer incidence experience of a 10% sample of the Canadian labour force has been monitored by using computerized record linkage to the Canadian National Mortality and Cancer Incidence Data Bases. Occupation and industry data are available for the sample for the years 1965-1971, and the data are being used both to generate and test hypotheses concerning occupational exposures and increased risk of various cancers. It is planned to continue the monitoring process in future years, and as the number of cancer cases and deaths in the cohort accumulate, the data will provide an increasingly valuable utility for cancer researchers.

Adult↗
PubMed1979

Isoniazid exposure in relation to cancer incidence and mortality in a cohort of tuberculosis patients.

41 226 isoniazid exposed and 22 811 non-exposed patients admitted to Canadian institutions for the treatment of tuberculosis from 1952 to 1960 were followed to 1973 by computerised record linkage to the National Death Index and, for 1969 to 1973, to the National Cancer Incidence Reporting System; The mortality for the total cohort compared to that expected from the mortality in the Canadian population, was greater than expected for tuberculosis, other chest diseases and certain cancer sites associated with cigarette smoking (except bladder cancer). There was, however, no difference between the isoniazid-exposed and non-exposed in mortality from all cancer and individual cancer sites, except for oesophageal cancer in males. Cancer incidence from 1969 to 1973 was also similar for the isoniazid- exposed and non-exposed groups. An elevated standardised incidence ratio was seen only for buccal cavity and pharynx in male exposed subjects. It is concluded that this study provides additional negative evidence on the carcinogenicity of isoniazid in man.

Adolescent↗
PubMed1979

Long-term outcome in children with temporal lobe seizures. I: Social outcome and childhood factors.

One-hundred children, diagnosed as having temporal lobe epilepsy and reported on in 1966, have been followed into adult life. In this 1977 survey they have been coded into four social outcome categories, A, B, C and D. A: 33 per cent are found to be seizure-free and independent; B: 21 per cent are socially and economically independent but are receiving anticonvulsant treatment and are not necessarily seizure-free; C: O9 per cent are dependent either on their parents or in institutions; D: 5 per cent died under the age of 15. Biological factors ascertained and coded in childhood are related to adult outcome. Eight adverse factors emerged: an IQ below 90, onset of seizures before 2 years 4 months, five or more grand mal attacks, temporal lobe seizure frequency of one per day or more, a left-sided focus, the hyperkinetic syndrome, catastrophic rage and special schooling. The presence of first-degree relatives with seizure disorders was a good prognostic sign. Disorderly homes in childhood did not significantly affect adult outcome. All but one of those achieving Group A status had received normal schooling. In general, the prognosis for children with limbic seizures is clear before the end of adolescence. A simple count of the number of childhood adverse factors predicts adult outcome at a high level of significance.

Adolescent↗
PubMed1979

Long-term outcome in children with temporal lobe seizures. II: Marriage, parenthood and sexual indifference.

One-hundred unselected children with clinical and EEG evidence of temporal lobe seizures were followed into adult life. Data related to marriage and reproduction are analysed. Female survivors, if not totally handicapped, are nearly all married; surviving males who are not totally handicapped more often remain single. Early remission of seizures in males is associated with marriage: seizures continuing through adolescence are associated with sexual appetitive indifference. The female probands have produced children at a rate three times greater than the male probands. The findings have implications for understanding the development of male secual appetite. The epidemiology and genetics of these forms of seizures must take account of much greater fitness on the distaff side of the pedigree. The likelihood of marriage and parenthood would appear to rest on a few biological factors usually recognisable before the end of childhood.

Adolescent↗
PubMed1979

Long-term outcome in children with temporal lobe seizures. III: Psychiatric aspects in childhood and adult life.

One hundred children with temporal lobe epilepsy were followed into adult life. 85 per cent had had psychiatric problems in childhood. The occurrence of overt psychiatric disorder in adult life was low: of those survivors who were not gravely mentally retarded, 70 per cent were regarded as psychiatrically healthy. Overt schizophreniform psychosis has developed in 10 per cent of survivors. Males with continuing epilepsy and left-sided foci were at special risk: 30 per cent of such patients had become psychotic. No patient coded as having a right-sided focus in 1964 had become psychotic by 1977. Though 26 patients had had grossly disordered childhood homes, this factor had no significant relation to adult psychiatric disorder. Antisocial conduct marked the adult life of 12 patients. Their childhood codes showed that male sex, a focus contralateral to the preferred hand, and unremittent epilepsy marked this group. Low intelligence and childhood rages were also prominent. Treated neurotic and depressive illness was quite uncommon. Only five survivors have fallen into this category. Those patients escaping psychiatric ill-health are often notably extraverted and successful.

Adult↗
PubMed1978

Traumatic coronary artery fistula.

We report certain diagnostic and therapeutic problems presented by patients with traumatic coronary arteriovenous or arteriocameral fistulas, based on our experience with one case and our review of cases which have previously been reported in detail.

Adult↗
PubMed1977

Arrhythmias in the post CCU phase of myocardial infarction: their correlation with the acute illness.

To estimate the frequency of potentially life-threatening arrhythmias in myocardial infarction following transfer from the coronary care unit (CCU) and to identify features of the acute illness which predict such events, 66 patients were monitored on-line by means of a computer assisted system. Premature ventricular contractions (PVCs) were detected following transfer from the CCU in 64 patients (97%). In 29 (44%) they fell in classes 2 to 4 of Lown. Accelerated ventricular rhythm was detected in five and ventricular tachycardia in three. The presence of these rhythm disturbances did not correlate with age, sex, infarct location, the occurrence of previous infarction, the level of serum cardiac enzymes, the presence of heart failure, atrial arrhythmias, heart block, or serious ventricular arrhythmia in the CCU. Use of procaine amide or quinidine for persistent ventricular arrhythmia in the CCU was correlated with detection of class 2, 3 or 4 PVCs. Thus, PVCs are nearly universal in the late phase of hospitalization for myocardial infarction. Frequent and complicated PVCs are common and occur most frequently in individuals in whom such events have been persistent in the CCU.

Acute Disease↗
PubMed1976

Mortality from cancer of the uterus in Canada and its relationship to screening for cancer of the cervix.

Age-standardized death rates at ages 30-64 from cancer of the uterus in the 10 provinces of Canada have been assessed in 1950-52, 1960-62 and 1970-72, and changes in rats over these periods related to screening for cancer of the cervix and variables derived from the censuses of 1961 and 1971. Death rates at the county and census division level have also been assessed for the provinces of Nova Scotia, Quebec, Ontario, Manitoba and Alberta for 1960-62 and 1970-72 and related to screening and census-derived variables. There is little indication of a contribution of screening to the fall in death rates that occurred in eight of the 10 provinces from 1950-52 to 1960-62. There is, however, evidence of an important and significant contribution of the intensity of screening (as indicated by the number of cervical cytology examinations conducted in 1966 expressed as a rate per 1,000 female population aged 20 or more) to the fall in death rates at both the provincial and county or census division levels from 1960-62 to 1970-72, and this effect is not abolished by taking the census-derived variables into account. It is concluded that a significant effect of intensity of screening on the reduction in mortality from cancer of the uterus in Canada in the age-group 30-64 over the period 1960-62 to 1970-72 has been demonstrated.

Adult↗
PubMed1976

Electrocardiographic radiotelemetry in the early recuperative period of acute myocardial infarction. Its value in detecting arrhythmias in the setting of a progressive coronary care unit.

One hundred seventeen consecutive patients with acute myocardial infarction transferred from the coronary care unit to a progressive coronary care unit were monitored by electrocardiographic radiotelemetry for a median of five days for arrhythmia detection. Eighty patients (68%) had arrhythmias; 37 patients (32%) had none. Almost all arrhythmias were detected by the sixth day of monitoring. Thirty-nine patients (33%) had premature ventricular contractions, two patients had primary ventricular tachycardia, one patient had primary ventricular fibrillation, and two patients had secondary ventricular fibrillation. An additional patient was successfully resuscitated after monitoring had been discontinued. Four (3%) of 117 patients had a potentially lethal arrhythmia treated successfully, three while being monitored. Twenty-five of the patients (21%) had 33 episodes of treatment intervention because of telemetrically detected events. Five patients (4%) died, all of unpreventable causes. No patient died because of an arrythmia. We conclude that telemetry is feasible and practical in detecting arrhythmias. It is clear that potentially fatal ventricular arrhythmias do occur following transfer from the coronary care unit and that monitoring is, therefore, desirable.

Acute Disease↗