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Biomedical subjects

J Petrie

Publications and source records attributed to J Petrie.

At least 37 records · Page 2Linked to original sources
PubMed1995

Risk factors for ischaemic heart disease and stroke mortality in young and old hypertensive patients.

We investigated the predictors of cardiovascular mortality at different ages in a longitudinal study of 10186 hypertensive patients attending clinics in the UK. There were 7374 patients (51% were men) < 60 years of age and 2799 patients (44% men) were > or = 60 years. For IHD death the age-adjusted relative risks (RRs) and 95% confidence intervals (CI) for a 1 mmol/l increase in cholesterol were RR = 1.17 (1.07, 1.27) (men) and RR = 1.22 (1.12, 1.33) (women). The RRs for stroke were 0.99 (men) and 1.07 (women). In men and younger women, urea and smoking were important predictors of IHD and stroke death. Age differences were present in women for both urea and smoking. For IHD in women, smoking: RR = 2.65 (1.80, 3.89) (< 60 years) and RR = 1.38 (1.01, 1.88) (> or = 60 years). For stroke in women, smoking: RR = 2.03 (1.23, 3.35) (< 60 years) and RR = 1.06 (0.70, 1.61) (> or = 60 years). We conclude that urea and smoking are important risk factors for stroke and IHD death in hypertensive women aged < 60 years, but are less important in those aged over 60 years. Cholesterol predicted IHD death in all men and women, but did not predict stroke death.

Adult↗
PubMed1994

Effects of adrenergic agonists on the growth and gene expression of the transplanted heart.

Cardiac growth occurs in response to changes in hemodynamic demand and results primarily from cellular hypertrophy without cellular hyperplasia. In addition to changes in cardiac work, various reports have demonstrated that adrenergic stimulation, specifically of the alpha 1 adrenergic receptor of cultured myocytes, can produce changes in cardiac-specific gene expression and increases in protein synthesis and cell growth. To study the effects of adrenergic stimulation in the absence of alterations in cardiac work we have used the model of the heterotopically transplanted heart, which is a spontaneously beating, vascularly perfused, and histologically normal heart that is hemodynamically unloaded. Seventy-two hours after transplantation, the hemodynamically unloaded transplanted heart had decreased in size by 20% when compared with the control host heart that was growing in situ. Treatment with either the alpha-adrenergic agonist phenylephrine (2.5 mg/kg/day) or the beta-adrenergic agonist isoproterenol (250 micrograms/kg/day) while increasing the spontaneous heart rate had no effect on the size of the transplanted heart. Simultaneous measurements demonstrated that both of these drugs produced a 10% increase in weight of the corresponding hemodynamically loaded host heart. We previously demonstrated that cardiac unloading caused a change in the expression of the myosin heavy chain (MHC) genes with a significant increase in the beta MHC isoform. In the present studies treatment with either isoproterenol or phenylephrine did not alter MHC gene expression either in the in situ host or transplanted hearts.(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenergic Agonists↗
PubMed1991

The social and psychologic factors of bruxism.

Bruxism is a destructive habit that is defined as the nonproductive diurnal or nocturnal clenching or grinding of the teeth. This study investigated whether the combination of physical abnormalities, type A behavior pattern, and the perceived desirability and controllability of life stress are related to bruxism. The subjects for the study were 125 dental patients who were classified as bruxers or nonbruxers by a licensed dentist and who completed two measures, the Jenkins Activity Survey, and a modified version of the Holmes and Rahe Life Events Scale. Regression analyses indicate there is a difference in the separate impact of each variable. Type A behavior and physical abnormalities are significant in a stepwise analysis, while stress is not. Stress appears to be significant only in conjunction with type A behavior, and suggests that the combination of type A behavior, and stress is more predictive of bruxism than either of the individual variables. The linear combination of physical abnormalities, type A behavior, and stress is significant, and suggests that it is the best predictor of bruxism.

Bruxism↗
PubMed1990

Surgical treatment of chronic aortic dissections.

Between January 1976 and March 1987, 78 patients underwent surgery for chronic aortic dissection at our institution. The ascending aorta was involved in 66 cases (Stanford type A) and was not involved in 12 cases (Stanford type B), wherever the initial dissection was suspected. Aortography remains the main preoperative investigation. The surgical technique varies according to the type of dissection. It seems essential to exclude the primary intimal tear and all dilated segments of the aorta must be replaced. The overall operative mortality was 11.5% (7.5% in type A, 33.3% in type B dissection). Sixty-three patients have been followed for a period varying between 6 months and 10 years (mean 5 years). The overall survival at 6 years is 60% +/- 5.6%. Because of the ultimate risk of aneurysmal dilatation of the false channel, these patients must be followed by CT scanning, colour flow Doppler echocardiography, magnetic resonance imaging, and in some cases, aortography.

Aortic Dissection↗
PubMed1990

The British Hypertension Society protocol for the evaluation of automated and semi-automated blood pressure measuring devices with special reference to ambulatory systems.

With the increasing manufacture of expensive systems for the measurement of ambulatory blood pressure there is a need for potential purchasers to be able to satisfy themselves that the systems have been evaluated according to agreed criteria. The British Hypertension Society has, therefore, drawn up a protocol of requirements for the evaluation of these devices. This protocol incorporates many features of the American National Standard for Non-Automated Sphygmomanometers but includes many additional features, such as strict criteria for observer training, interdevice variability testing before and after a month of ambulatory use, and a new system of analysis which permits the test system to be graded. It is recommended that manufacturers of ambulatory blood pressure measuring devices should obtain an unbiased evaluation according to a recognized standard before a device is marketed.

Blood Pressure Monitors↗
PubMed1990

Approach to advanced aortic root infection.

Among our first 11,620 cases of valvular replacement, we observed 285 cases of valvular endocarditis and 59 cases (20.7%) in which the importance of the infectious lesions of the aortic or mitral annulus required complex valvular repair. In 23 patients with aortic valvular endocarditis, the presence of an abcess of the aortic annulus required its closure with a patch resulting in one early and one late death and five reinterventions with one death. Twenty patients are alive and well, 1 to 9 years after operation. In 11 patients, the extent of annular abcesses required the insertion of a subcoronary valved conduit. After a maximum follow-up of 8 years there were two early deaths, two late deaths, one reoperation, and seven good results. Twelve patients had a supracoronary valved conduit resulting in four early deaths, one late death, and two reoperations; seven are alive and well, 2 to 6 years later. Three patients previously operated on had a left ventricular abdominal aorta valved conduit, two of them are alive and well up to 6 years later. Severe infectious lesions of the valvular rings (aortic root) can require complex repairs that can be lifesaving and provide excellent long-term results.

Abscess↗
PubMed1989

[Results of simultaneous myocardial and cerebral revascularization surgery].

Out of 3,678 patients who underwent aorto-coronary bypass between May, 1979 and October, 1987 at the La Pitié Hospital, Paris, 48 had simultaneous myocardial and cerebral revascularization. Operative mortality rate was 4.2 p. 100. Peri-operative myocardial infarction occurred in 3 cases (6.2 p. 100). No neurological complication was observed. The survival rate at 5 years (operative mortality included) was 74.8 +/- 8.66 p. 100. These results obtained in patients with multiple arterial disease are in agreement with those found in the literature. The lack of neurological complications is in favour of a systematic combined surgical treatment of severe carotid and coronary lesions.

Aged↗
PubMed1989

[Delayed autotransfusion associated with the cell-saver method in cardiovascular surgery. Values, methods, initial results].

The aim of deferred autotransfusion associated with the Cell-Saver system, i.e. the recovery of intraoperative blood loss, is to avoid using external homologous blood products. Transfusion-transmitted diseases and immunisation problems can be avoided: normovolumic haemodilution is an advantage in patients with coronary artery disease and economies can be made in the use of homologous blood. This technique has been in use in Professor Cabrol's department since 1987 with the help of the Blood Transfusion Centre of the Pitié Hospital. The contraindications are unstable angina, severe cardiac failure and anaemia of less than 11 g Hb at the first consultation. A review of the first 65 patients included in the protocol showed that deferred autotransfusion was well tolerated in all cases and that only 10 per cent of patients required transfusion with homologous blood. Autotransfusion associated with the Cell-Saver system is therefore a good method which should be extended to the largest possible number of patients referred for elective cardiac surgery.

Adult↗
PubMed1989

[Heart myxoma. Surgical treatment].

We reviewed all the patients who underwent surgical excision of cardiac myxomas at La Pitié during the last fifteen years. Fifty-one cases were found (32 female and 19 male) aging from 16 to 75 years (mean 51). Congestive heart failure was the primary symptom present in 28 patients. Thirteen patients presented peripheral embolization, four with syncope and 11 with tachyarrhythmias. The diagnosis was made either by echocardiography or angiography. All of them had correct preoperative diagnoses, and no tumors were found incidentally at operation. Forty-six myxomas were localized in the left atrium, four in the right atrium and one in the right ventricle. All the patients underwent open-heart operation and myxomas were successfully removed with excision of a portion of normal atrial septum or wall. Path reconstruction of the atrial septum was required thirty-six times. Mortality after surgical excision is very low. Only one death (1.96%) occurred as a result of a postoperative low output syndrome. Late recurrences have been reported in other series, but no recurrences were diagnosed in our patients up to the present. Although the recurrence rate is low, long-term clinical and echocardiographic follow-up is recommended.

Adolescent↗
PubMed1988

The corpus callosum is larger with right-hemisphere cerebral speech dominance.

Variations in the size of the human corpus callosum were examined as a possible morphological substrate of functional asymmetries of the cerebral hemispheres, such as cerebral speech dominance. The midsagittal surface area of the corpus callosum, obtained by magnetic resonance imaging, was measured in 50 patients with epilepsy and 50 neurologically normal control subjects. The mean callosal area did not differ significantly between patients and control subjects, between left-handed and right-handed subjects, or between men and women. When measurements were compared among 44 patients, whose cerebral speech dominance had been determined by the intracarotid injection of sodium amytal, the area of the corpus callosum was significantly greater in patients with right-hemisphere cerebral speech dominance. The mean callosal area was greater by 109 to 159 square millimeters (18-28%) when compared to that of patients with either left-hemisphere speech dominance or bilateral speech representation. This difference in midsagittal surface area could represent as many as 37 to 54 million additional callosal axons in subjects with right-hemisphere cerebral speech dominance.

Adolescent↗