Biomedical subjects
P C Barnes
Publications and source records attributed to P C Barnes.
Microembolism from aortic aneurysm and ventricular thrombus: a complication of intravenous streptokinase.
Two patients sustained the rare complication of skin infarction following administration of intravenous streptokinase for acute myocardial infarction. We report evidence that dissolution of thrombus from an unsuspected source and subsequent microembolization of the skin may be responsible for this complication. In patients known to have an aortic aneurysm or ventricular thrombus, careful consideration should be given to the use of intravenous streptokinase following myocardial infarction.
Influence of anticardiolipin antibodies on immediate patient outcome after myocardial infarction.
AIMS: To determine whether the presence of anticardiolipin antibodies in patients with suspected myocardial infarction is predictive of complications during hospital stay or after discharge. METHODS: Anticardiolipin antibodies were serially measured in a cohort of 111 patients, from the time of admission to the coronary care until till eight weeks after discharge. Associations with fatal and non-fatal cardiac complications were documented. RESULTS: The incidence of raised titres of IgG and IgM anticardiolipin antibodies (ACA) in patients with myocardial infarction was comparable with that in patients with ischaemic heart disease. ACA titres in patients with a previous myocardial infarct were not significantly different from those found in patients without a previous history of infarction. Over the period of the study, ACA titres in the myocardial infarct group did not change significantly from those recorded on admission, nor did those patients with raised ACA titres have a higher prevalence of complications in hospital or in the early period after discharge. CONCLUSIONS: There is no evidence that patients with an acute or previous myocardial infarct have higher ACA titres than those found in patients with ischaemic heart disease. Raised ACA titres soon after myocardial infarction do not influence immediate patient outcome.
Fatal haemoptysis from the pulmonary artery as a late complication of pulmonary irradiation.
Explore the source record for details and available documents.
Plasma lipids: when to measure after myocardial infarction?
Current medical textbooks do not give clear advice on the optimal time to measure plasma lipids following myocardial infarction. Many physicians still defer the measurement for three months. We studied the plasma lipids in 132 patients with myocardial infarction. Measurements were made on admission and 24, 48 and 72 hours later and 103 patients had their plasma lipids measured at three months. Forty-three patients had hypercholesterolaemia (cholesterol greater than 7 mmol/1) at admission. Total cholesterol and low density lipoprotein fell appreciably in the first three days after myocardial infarction. The former returned almost to its admission level by three months, whilst the latter did not. Triglycerides showed no important changes, whilst high density lipoprotein levels had significantly increased at three months. Total cholesterol levels at three months were different from the 24, 48 and 72 hour values. Our findings suggest that plasma lipids should be measured on admission after myocardial infarction. Deferring the measurement by one or two days will give results which may not reflect pre-infarction levels.
Levodopa and congestive cardiomyopathy.
Explore the source record for details and available documents.
Echocardiographic diagnosis of quadricuspid aortic valve.
Isolated quadricuspid aortic valve is very rare. The identification of this malformation can be made by cross-sectional echocardiography. Two cases of quadricuspid aortic valve diagnosed by cross-sectional echocardiography are described.
Left ventricular thrombosis in acute transmural myocardial infarction.
To determine the incidence and natural history of left ventricular thrombosis in acute transmural myocardial infarction we performed serial two-dimensional echocardiography in 51 patients. Seventeen patients had inferior infarcts. None of these developed left ventricular thrombosis. The remaining 34 patients had anterior infarcts. Ten of these developed left ventricular thrombus at an average of 4 +/- 2 days after admission. All patients with left ventricular thrombosis had apical akinesia or dyskinesia. Patients with anterior myocardial infarction and akinesia or dyskinesia of the apex are at high risk of developing left ventricular thrombosis. Peak aspartate aminotransferase and lactate dehydrogenase enzyme activity were of little value in identifying this high risk group.
Myocardial infarction: a complication of amitriptyline overdose.
A 22 year old woman was admitted with amitriptyline overdose. Twenty six hours later she developed acute myocardial infarction. Cardiotoxic effects of tricyclic antidepressants are discussed and the importance of considering myocardial infarction as a complication of tricyclic antidepressant overdose is emphasized.
Monotherapy with felodipine, a new calcium antagonist, in mild and moderate hypertension.
The role of felodipine, a new calcium antagonist, in monotherapy for mild and moderate hypertension was investigated in a placebo-controlled double-blind study of 109 patients from 13 centres. The patients were randomised in a double-blind fashion to receive felodipine, 2.5 mg b.i.d. (32 patients), 5 mg b.i.d. (30 patients), 10 mg b.i.d. (24 patients), or placebo (23 patients). Two hours after the first tablet was administered, there was a reduction in systolic and diastolic blood pressure, both supine (p less than 0.05) and standing (p less than 0.001), that was significantly correlated with dose. Three and 8 weeks later, 2 h after dosage, this correlation was still apparent in both supine and standing blood pressure (p less than 0.001). One week after randomisation, at 12 hours after administration there was a significant correlation with dose in the standing systolic (p less than 0.05) and diastolic (p less than 0.01) blood pressure. After 8 weeks therapy, a significant correlation with dose occurred in both supine and standing systolic (p less than 0.05) and diastolic (p less than 0.01) blood pressure 12 h after therapy. The proportion of patients completing the study who achieved a supine diastolic blood pressure of 90 mm Hg or less after 8 weeks therapy at 2 h after dosage was 9% on placebo, 67% on felodipine 2.5 mg b.i.d., 57% on felodipine 5 mg b.i.d., and 92% on felodipine 10 mg b.i.d. Felodipine was generally well tolerated although 10 patients on the highest dose withdrew due to adverse experiences. Plasma felodipine levels were significantly correlated with dose.(ABSTRACT TRUNCATED AT 250 WORDS)
Ambulatory electrocardiographic monitoring in a market town health centre.
An ambulatory electrocardiographic monitoring system was made available to a group of 10 general practitioners in one health centre and the use of the service was studied over a period of 12 months. The participating doctors were asked to assess the value of the reports received and to indicate any effect on patient management. Over the year 77 recordings were made for 73 patients and among the 69 technically satisfactory recordings 10 abnormalities were detected. A considerable variation in the use of the service by the doctors was detected but overall they appeared to find the reports received helpful. The management of 48 of the patients was changed as a result of the investigation. Results from a two-year follow-up period suggested a steady request rate for recordings of approximately two requests per 1000 patients per year. The detection rate of abnormalities following recording was 11% for the three years combined. Such a system has a valuable place in the management of some patients.
Intravenous and oral disopyramide after myocardial infarction.
Patients with acute myocardial infarction admitted to a coronary care unit were given either intravenous and oral disopyramide or matching placebo on admission and throughout their hospital stay. 199 patients entered the trial, and 138 were subsequently shown to have had a myocardial infarct. The placebo and study groups were well matched. There were no significant differences in mortality or observed arrhythmias between the two groups. These results do not confirm earlier observations that prophylaxis with disopyramide reduces mortality after acute myocardial infarction.
Hypokalaemic myopathy and myoglobinuria due to carbenoxolone sodium.
Explore the source record for details and available documents.
Sensitive procedure for aflatoxin detection in peanuts, peanut butter, peanut meal, and other commodities.
Explore the source record for details and available documents.
Non-Hodgkins lymphoma presenting with evidence of right ventricular outflow tract obstruction.
Anterior mediastinal tumours have been reported that initially presented with signs suggestive of cardiac disease. The widespread availability of two-dimensional echocardiography has demonstrated that, in the majority of cases, right ventricular compression is the major cardiac complication of such masses. We report two cases of mediastinal lymphoma that presented with chest pain and signs of right ventricular outflow obstruction.