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Biomedical subjects

K Daly

Publications and source records attributed to K Daly.

At least 91 records · Page 5Linked to original sources
PubMed1983

Traumatic right coronary artery--right atrial fistula.

Traumatic coronary artery fistulae and intracardiac shunts due to penetrating wounds of the heart are rare, with only 19 reported cases in the literature. The communication, which may involve one or both coronary arteries, is classified into two major types depending on whether the drainage is into the left or right heart. We report a right coronary artery (RCA) right atrial fistula (RA) secondary to shrapnel injury in 1944.

Angina Pectoris↗
PubMed1982

Q fever endocarditis.

Despite a worldwide distribution of Coxiella burnetii, only single cases of Q fever endocarditis have been reported outside Great Britain and Australia. We present 10 patients; five were female, only four had a history of environmental exposure, and the mitral valve was involved as commonly as the aortic stenosis, and three patients had a prosthetic valve. We confirm the importance of hepatic involvement, thrombocytopenia and hypergammaglobulinemia as diagnostic features. Diagnosis was established by finding and elevated complement-fixing antibody to Phase I C. burnetii antigen. Tetracycline, with or without lincomycin or cotrimoxazole, was used in nine patients, and one patient received cotrimoxazole as as the sole antibiotic agent. Optimal duration of therapy is unknown. In one patient, relapse followed when treatment was stopped after 18 months. Valve replacement was necessary in five patients, because of hemodynamic problems. Five patients died, and the means survival is 36 months with a range of five to 66 months. We suggest that Q fever endocarditis is frequently missed, and we recommend clinicians to consider the diagnosis in all cases of culture-negative endocarditis.

Adult↗
PubMed1981

Prostacyclin: haemodynamic and metabolic effects in patients with coronary artery disease.

The therapeutic potential of prostacyclin was evaluated in 10 patients with angina pectoris and angiographically proved coronary artery disease. Platelet aggregation and coronary and systemic haemodynamic effects were examined before and after intravenous infusions of 2, 4, 6, and 8 ng/kg/min of prostacyclin and were dose related. At 8 ng/kg/min the ADP concentration required to induce 50% of maximum platelet aggregation increased from 1.8 to 4.5 mumol/l (p less than 0.001). Heart rate and cardiac index rose from 77 to 93 beats/min and 2.47 to 3.48 l/min/m2, respectively (p less than 0.01). Mean blood pressure and systemic and pulmonary resistances fell from 107 to 92 mm Hg and 1704 to 1048 and 80 to 45 dyn s cm-5, respectively (p less than 0.01). Coronary vascular resistance also fell from 0.95 to 0.73 units (p less than 0.01). Mean atrial pacing time to angina rose from 142 to 241 s (p less than 0.05), while lactate production during rapid atrial pacing was decreased, lactate extraction ratio rising from -25 to -9% (p less than 0.05). These coronary and systemic vasodilator effects and the prolongation of pacing time to angina indicate an acute beneficial effect of prostacyclin on angina. Since prostacyclin has been shown to prevent platelet accumulation and progression to total occlusion in animals with experimental coronary stenoses, the observed inhibition of platelet aggregation suggests that prostacyclin should be further evaluated in unstable angina.

Angina Pectoris↗
PubMed1981

Selection associated with the alcohol dehydrogenase locus in Drosophila melanogaster: differential survival of adults maintained on low concentrations of ethanol.

David and his collaborators have reported that adult Drosophila melanogaster survive longer on 2 per cent ethanol than on distilled water, but that the increased survival on ethanol does not occur in mutant flies lacking alcohol dehydrogenase activity. This has led us to enquire if the polymorphic alleles at the alcohol dehydrogenase locus (AdhF and AdhS), which code for enzymes with different activities, affect survival on low concentrations of ethanol. Flies were kept in sealed glass chambers containing either 2 per cent ethanol or distilled water. In four experiments, comprising a total of 126 replicates, the proportion of surviving FF flies, relative to SS, was greater on ethanol than on water. In two experiments the excess was highly significant. It appears that FF flies are better able than SS to use ethanol as food. Our results support the view that selection acts directly on the Adh polymorphism.

Alcohol Oxidoreductases↗
PubMed1980

Cyclophosphamide, vincristine, methotrexate with leucovorin rescue, and cytarabine (COMLA) combination sequential chemotherapy for advanced diffuse histiocytic lymphoma.

A program of combination sequential chemotherapy using cyclophosphamide, vincristine, methotrexate with leucovorin rescue, and cytarabine (COMLA) was administered to 42 previously untreated patients with advanced diffuse histiocytic lymphoma. Twenty-three patients achieved a complete remission as determined by strict clinical restaging criteria. The observed median duration of survival for the complete responders is longer than 33 months. Eight patients achieved a partial response, with a median survival longer than 21 months. Eleven patients showed no response, with a median survival of 5 months. Toxicity was acceptable. None of the responders have shown central nervous system relapse. There was no difference in response rates between patients with stage III or IV lymphoma or between asymptomatic or symptomatic patients. The COMLA program produces a high rate of complete and durable remissions and should be considered as an initial form of management of patients with advanced diffuse histiocytic lymphoma.

Adolescent↗
PubMed1979

Angiocardiographic appearances of atrioventricular defects with particular reference to distinction of ostium primum atrial septal defect from common atrioventricular orifice.

Preoperative distinction between common atrioventricular orifice and ostium primum atrial septal defect may be difficult. To improve diagnostic accuracy, the right and left ventricle angiocardiograms were reviewed 'blind' in 92 patients with atrioventricular defects. The true diagnosis was known from necropsy or surgery in 60. Angiocardiograms had been obtained in various projections with or without craniocaudal tilt. Those features thought to distinguish between common orifice and ostium primum were coded, together with the ventricular systolic pressures. Computerised disciminant function analysis identified the following distinguishing features: (1) right ventricular systolic pressure; (2) immediate right ventricular outflow tract opacification from the left ventricle; (3) identification of the anterior attachment of the mitral component; (4) recognition of a single straddling atrioventricular orifice; (5) passage of contrast medium above or below the anterior or posterior bridging leaflets. Feature (3) indicates that in contrast to classic teaching the direct septal attachment of the mitral component does not contribute to the 'gooseneck' in complete atrioventricular defects. The significance of (4) and (5) is that they may be identified from right as well as left ventriculography, and are more likely to be identified in oblique than standard projections. Computerisation produced a correct diagnosis in 92 per cent of known cases, and determined precise probabilities of diagnosis in the remainder.

Angiocardiography↗
PubMed1979

Angiocardiography in the pre-operative evaluation of patients with univentricular hearts.

Diagnosis of the univentricular heart and recognition of its most important variations depends on the establishment of atrial situs, the demonstration of the type and mode of the atrio-ventricular connexion, the identification of the presence or absence of a rudimentary chamber, the establishment of its morphology, together with that of the main chamber, and classification of the arterial connexion. A logical means of demonstrating these features is presented, depending on bronchial visualization, one or possible two injections of contrast medium into the main chamber, followed if necessary by selective injection into the rudimentary chamber, and in exceptional cases, demonstration of the atrial septum by atrial injection. The advantagess of cranio-caudal tilt and oblique projections are discussed in detail.

Angiocardiography↗
PubMed1975

Quantitative dose-response of growth and development in Arabidopsis thaliana exposed to chronic gamma-radiation.

The response of Arabidopsis thaliana (L.) Heynh. (Cruciferae) to a gradient of chronic gamma-radiation was examined under field conditions. Plants that were initially introduced to the gamma field as dry seeds received exposures of 1-34 to 18 800 R/20 hour day from the time of seed germination. Regression analysis demonstrated a significant, but non-linear, response for three variables, number of seedlings emerging, number of plants flowering, and plant volume; the response of a fourth variable, number of leaves per plant, was not related to daily exposure. LD50 values ranged from 66 R/20 hour day for plant volume to 1231 R/20 hour day for seedling emergence. Flowering and plant volume were the most sensitive indicators of radiation exposure. The demonstration of a variable threshold at low levels of exposure indicates that in nature A. thaliana may be exposed to environmental radiation throughout its life-cycle without significant modification of growth or development.

Dose-Response Relationship, Radiation↗
PubMedDate not supplied

The role of cardiac troponin I in determining the necessity for exercise electrocardiography in low risk patients with chest pain.

BACKGROUND: Assessment of non-cardiac chest pain places a considerable burden on healthcare resources. The current practice of serial electrocardiographs (ECGs), serum creatinine phosphokinase and by pre-discharge exercise electrocardiography gives an average in-hospital stay of 3.7 days. AIMS: This study assess the use of a sensitive assay for cardiac troponin I (cTnI) to identify a low risk group for whom exercise ECG may not be indicated. METHOD: Ninety-five patients with acute chest pain and with peak cTnI < 0.1 ng/ml and a non-diagnostic resting ECG were studied. Patients were divided into two groups. Group one had normal range cTnI (< 0.03 ng/ml). Group two had minimal elevation of cTnI (0.03-0.099 ng/ml). Average follow-up was 172 days. RESULTS: Nineteen patients had minimal elevation in cTnI of whom five developed significant ST shift on exercise and five had adverse events. No patient with a normal range cTnI had a positive stress test and none suffered an adverse event (p < 0.001). CONCLUSION: CTnI in the normal range can identify patients with acute chest pain who have a negligible event rate and for whom exercise electrocardiography is not required.

Chest Pain↗
PubMedDate not supplied

The provision of secondary cardiac prevention measures in a hospital cardiac clinic population and the relationship to psychological variables.

BACKGROUND: Implementing preventive measures in patients with established heart disease is one of the most effective health promotion activities, but there is little research on the relationship between cognition and secondary preventive behaviour. AIM: To determine the provision of secondary cardiac prevention measures among patients with established heart disease attending a cardiac outpatient clinic. METHODS: The study was conducted in an outpatient department over a 14-week period in 1999. Management of risk markers was noted from the medical records and lifestyle and psychological variables were self-reported. RESULTS: Of 294 patients with heart disease, 41% were available for study. Fourteen per cent were current smokers, one-quarter of males and one-third of females had a body mass index (BMI) greater that 30. Almost 90% attend their GP bimonthly, 67% had a normal systolic and 88.3% a normal diastolic pressure, 34% had normal cholesterol levels and 75% were on aspirin. Lifestyle variables were significantly affected by patient cardiac knowledge, sense of control over their heart disease and perceptions of their illness. CONCLUSIONS: These results highlight the potential health gain available to patients with established heart disease. The results also suggest that psychological factors may play a role in patients' health behaviours.

Coronary Disease↗
PubMedDate not supplied

Qualitative investigation of the meanings of eating fruits and vegetables for adult couples.

OBJECTIVE: The purpose of this study was to develop a substantive theory expressing the meanings couples associated with eating fruits and vegetables. DESIGN: This inductive qualitative study was based on a grounded theory approach and employed the constant comparison method of data analysis. Data were collected using semistructured individual interviews and a life history approach. SUBJECTS: Ten adult couples, aged 20 to 60 years, with and without children, all of whom were born in North America, were recruited using modified snowball sampling. RESULTS: Two overarching themes emerged. The "should syndrome" describes a morality concerning fruit and vegetable consumption arising from a tension between the low status of these foods in participants' childhood homes and their contemporary idealized status. The creation of couple gastronomies expresses couples'efforts to construct their own food norms and practices within a context of changes in social norms and fruit and vegetable availability. The substantive theory, making choices that balance their lives, conveys the dynamic processes involved in participants' fruit and vegetable choices. IMPLICATIONS: Future research will determine the transferability of the "should syndrome" and new couples' receptiveness to trying new fruits and vegetables. Understanding the changing contexts of food choice may help nutrition professionals better support healthful eating.

Adult↗
PubMedDate not supplied

Quality of life after intensive care.

Quality of life must be assessed after patients have received intensive care. Long-term survival of intensive care patients should be evaluated. TISS (Therapeutic Intervention Scoring System) is an extremely useful tool for estimating the cost of treatment given to an individual patient. APACHE II (Acute Physiology and Chronic Health Evaluation) is an effective index for measuring severity of illness. Age of patient and severity of illness dramatically affect the cost of treatment in intensive care.

Cost of Illness↗