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Biomedical subjects

K Cunningham

Publications and source records attributed to K Cunningham.

64 records · Page 4Linked to original sources
PubMed1980

Late results of surgical treatment of transposition of the great arteries.

In summary, many of these patients have achieved a normal working capacity, but as a group there is a statistically significant reduction when compared to healthy children (p < 0.01). There was no significant difference between the group of patients who had their Mustard operation in infancy and later. As yet, there is no suggestion that the older patients, or those with the longest time interval between the operation and the exercise test, have a progressive reduction in working capacity. The decreased working capacity and moderate increase in ventilation suggests restricted cardiac output on exercise. This could be related to the abnormal heart rate response rather than indicating poor ventricular function. Equally, a restricted cardiac output on exercise may be due to inefficiency of atrial transport, tricuspid regurgitation or unmasked pulmonary vascular obstructive disease. Further studies may clarify these points. This study demonstrated that the exercise performance of asymptomatic patients 6-13 years after Mustard's operation was somewhat diminished, compared with a group of normal children. Nevertheless, these patients did lead and enjoy a normal life. Only longitudinal studies may bring the final answer to the important question: How many patients will be alive with normal or near normal exercise tolerance 40-50 years after Mustard's operation? Until such an answer is available, we believe that the Mustard operation should be used in the treatment of TGA, while the alternative techniques are carefully explored.

Arrhythmias, Cardiac↗
PubMed1978

Neonatal transport: a controlled study of skilled assistance. Mortality and morbidity of neonates less than 1.5 kg birth weight.

To attempt to demonstrate the need for skilled care of sick neonates in transport, a modified randomized controlled study of infants being transported to this institution was carried out. Although special equipment was used, ambulances were not modified. Results of the first phase reported here show that infants weighing less than 1.5 kg at birth, transported by a trained physician and nurse, were significantly warmer, less hypotensive, and less acidotic on admission to the NICU. Mortality was significantly reduced, first week morbidity somewhat lessened, and duration of stay in hospital reduced by more than one third (P less than 0.01).

Ambulances↗
PubMed1976

Diet and growth in congenital heart disease.

To assess the relationship between diet and growth in congenital heart disease we studied nutrient intake, body measurements, and cardiac status in 568 affected ambulatory patients less than 11 years of age. Most had mild heart disease, 104 were cyanotic, and only 10 were in congestive heart failure. Major disturbances of growth were uncommon. For the entire group body weight was below normal but only in those studied before 2 years of age; rate of growth and weight gain were normal over the period preceding the dietary study. There was no statistically significant relationship between intake of calories, protein, or other nutrients and growth or gain, analyzing the entire group, or analyzing patients subgrouped according to age, severity of heart disease, or severity of growth retardation. Body size and growth were diminished in cyanosed compared with noncyanosed children but cardiac status had no effect on nutrient intake. We conclude that in children with growth failure associated with congenital heart disease, nutrient intake is not an important factor limiting their growth.

Body Height↗
PubMedDate not supplied

Comparative study of cefuroxime axetil and amoxycillin in the treatment of acute sinusitis in general practice.

Cefuroxime axetil was compared with amoxycillin in the treatment of acute and acute on chronic sinusitis in a multicentre general practice study. A total of 160 patients were randomized to receive 250 mg cefuroxime axetil orally twice daily, or 250 mg amoxycillin orally three times daily for 10 days. Of the 45 assessable patients with acute sinusitis 43 (96%) were cured or improved using cefuroxime axetil compared with 49 (94%) of the assessable patients in the amoxycillin-treated group. In patients with acute on chronic sinusitis, cefuroxime axetil resulted in an 80% (16/20) cure or improvement, with a 68% (13/19) response in the case of amoxycillin. Adverse events were mainly gastro-intestinal and none was considered serious in either treatment group, although three patients receiving cefuroxime axetil were withdrawn from treatment. It is concluded that cefuroxime axetil is at least as clinically efficacious as amoxycillin in the treatment of acute sinusitis in adults.

Acute Disease↗
PubMedDate not supplied

Comparative study of cefuroxime axetil suspension and amoxycillin syrup in the treatment of acute otitis media in general practice.

In a multicentre general practice study, 660 children aged between 3 months and 12 years with otitis media were randomized to receive a 10-day course of cefuroxime axetil suspension or amoxycillin syrup. Children under 2 years of age were given 125 mg cefuroxime axetil twice daily after food or 125 mg amoxycillin three times daily; older children received 250 mg cefuroxime axetil twice daily or 250 mg amoxycillin three times daily. The overall cure or improvement rate was 94.3% for those treated with cefuroxime axetil and 94.5% for those receiving amoxycillin. Both treatments were well tolerated, with no differences in the number of patients who experienced at least one adverse event or who were withdrawn from treatment. Haemophilus influenzae was isolated in 29% of specimens obtained, Streptococcus pneumoniae in 22% and Moraxella catarrhalis in 6%. Some Strep. pneumonia and M. catarrhalis infections were resistant to amoxycillin. It is concluded that cefuroxime axetil suspension given twice daily has comparable efficacy to amoxycillin syrup given three times daily in the treatment of children with otitis media.

Amoxicillin↗
PubMedDate not supplied

Cefuroxime axetil in the treatment of bronchitis: comparison with amoxycillin in a multicentre study in general practice patients.

Cefuroxime axetil 250 mg twice daily and amoxycillin 250 mg three times daily were compared in an investigator-blind, randomised, parallel group, multicentre study of acute or acute-on-chronic bronchitis. The two compounds had broadly similar efficacy. Analysis of patients on an intention-to-treat basis 24-72 hours after completion of the course of study medication showed that amoxycillin afforded clinical cure or improvement in 123/153 (80.4%) of patients and cefuroxime axetil in 109/143 (76.2%). This result was not significantly different, but the amoxycillin cure rate was not sustained and there were significantly more clinical relapses during the 4-week follow-up period following the end of treatment. Only 4/68 (5.9%) of patients receiving cefuroxime axetil relapsed and required further treatment, whereas 16/77 (20.8%) of those receiving amoxycillin needed further treatment (P = 0.016). These were all patients who had initially responded to treatment and had been adjudged clinically cured or improved. The significant difference in relapse rates suggests that the apparent clinical success with amoxycillin was not sustained. There were no differences between the two treatments in the numbers of patients experiencing adverse events, which were generally mild and transient.

Adolescent↗
PubMedDate not supplied

Outback psychiatry.

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Community Mental Health Services↗