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Biomedical subjects

P Carr

Publications and source records attributed to P Carr.

At least 19 recordsLinked to original sources
PubMed1992

Abnormal nondefect zone myocardial thallium washout ratio in patients with reversible thallium defects and normal coronary arteriograms.

Thallium myocardial defects in patients with no angiographic coronary artery stenosis have been attributed to attenuation effects and other artifacts. Of 323 patients having thallium myocardial imaging following dipyridamole infusion, 10 of 159 patients with a segmental perfusion abnormality were found to have no luminal diameter stenosis greater than 20% on coronary angiography and no electrocardiographic (ECG) evidence of myocardial infarction or left bundle branch block. A time-standardized regional thallium washout ratio was calculated as thallium myocardial counts with dipyridamole to counts without dipyridamole. In comparison to 10 age-matched control patients with no evidence of cardiac disease and no myocardial thallium defect, study patients had a lower regional myocardial thallium washout ratio from both the defect and nondefect (1.57 +/- 0.40 versus 2.27 +/- 0.92, p = 0.041) zones. Nine of the 10 study patients had independent evidence of noncoronary heart disease, including echocardiographic or ECG evidence of left ventricular hypertrophy in six patients. In patients with thallium defects and normal coronary arteriograms, a time-standardized regional thallium myocardial washout ratio for the nondefect zone may aid in the differentiation of patients with noncoronary heart disease from those with soft tissue artifacts.

Artifacts↗
PubMed1992

When wishes come true.

Explore the source record for details and available documents.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Injury surveillance in agriculture.

Information on agricultural trauma is limited and difficult to find. Planning for effective prevention strategies and evaluation is compromised by lack of a good surveillance system. Several agencies and organizations have provided some data. Although their summation is at best an approximation of the real situation, a critical review of current data bases is presented. The literature is also reviewed attempting to characterize agricultural trauma. This characterization was classified into: 1) case descriptions, 2) reviews of general articles on the hazards of farming, and 3) descriptive surveys of agricultural injuries. A summary of the available literature still leaves a rather superficial understanding of the entire injury picture. A new approach to surveillance is necessary to overcome past deficiencies. A combined modality approach is suggested, utilizing on-site survey, mail survey, telephone interviewing, and medical record verification. Trial applications of two such systems in Minnesota are described.

Accidents, Occupational↗
PubMed1990

The role of bipedal lymphangiography in testicular seminoma.

Determining the extent of intra-abdominal spread of testicular seminoma by radiographic studies is an essential step in planning rational treatment following orchidectomy. CT scanning is generally accepted as being superior to lymphangiography in assessing the retroperitoneal space. We reviewed the relative contribution of these two procedures in a retrospective analysis of 73 consecutive patients with testicular seminoma managed at Westmead Hospital between January 1980 and September 1987. Abdominal CT scans and bipedal lymphangiography (LAG) were carried out in 72 and 51 patients respectively, 50 patients undergoing both procedures. We found concordance between the two techniques to be 88%. Upstaging occurred in 5 patients using CT (10%), 7 patients using LAG (14%), and in 8 patients (16%) when both tests were utilised. Four patients were upstaged by both techniques while the remaining 4 patients were upstaged using one technique alone. Serum beta-HCG was not a reliable screen for residual disease. Residual disease in the few patients with an elevated serum beta-HCG was easily detected by CT scanning. We conclude that there is a continuing role for LAG in assessing patients with clinical Stage I seminoma when the abdominal CT scan is equivocal or normal.

Adult↗
PubMed1989

Effects of protracted hypothyroidism on pituitary function and structure in endemic cretinism.

Pituitary function and structure were assessed in 69 endemic cretins from western China. In hypothyroid cretins (TSH greater than 10 mIU/l), CT imaging of the pituitary revealed adenoma in five of 20 (25%) and partially empty sella (PES) in a further eight of 20 (40%). The majority of tumours were microadenomas and showed a relation with higher levels of serum TSH but not with duration of hypothyroidism. Dynamic pituitary testing with TRH and GnRH in four patients with adenoma on CT gave a flat TSH response but significant rises in serum PRL, GH, LH and FSH concentrations. Hyperprolactinaemia (greater than 350 mIU/l) was present in hypothyroid cretins only (13 of 26; 50%) and serum PRL showed a curvilinear relation with serum TSH levels (r = 0.7, P less than 0.0001). Hypogonadism was seen in approximately half the cretins with high PRL levels. Our data suggest that severe protracted thyroid hormone deficiency may result in thyrotrophin adenomas of the pituitary gland. Disturbances of growth, puberty, and sexual function in endemic cretins are explained by the secondary effects of thyroid hormone deficiency on pituitary function.

Adenoma↗
PubMed1987

Lisinopril in elderly patients with hypertension.

The antihypertensive efficacy and safety of lisinopril, a long-acting angiotensin-converting enzyme inhibitor, were assessed in 40 elderly patients (aged 65 years or over) with mild to moderate systolic/diastolic or isolated systolic hypertension, in an open study of 12 weeks' duration. Lisinopril was given orally in single daily doses. The starting dose was 5 mg in patients with glomerular filtration rate (GFR) of 30-60 ml/min and 10 mg in patients with GFR greater than 60 ml/min. The dose of lisinopril could be titrated upwards to a maximum of 40 mg daily according to blood pressure response. A thiazide diuretic was then added if blood pressure was not controlled. Thirty-six patients completed the study. Mean sitting blood pressure was significantly reduced by lisinopril treatment. There was no significant alteration in the heart rate, and postural hypotension did not occur. The median dose of lisinopril given was 20 mg daily (range 5-40 mg daily), and only two patients had a diuretic added to the lisinopril. One patient was withdrawn from the study because of unstable angina, and another was discontinued from lisinopril treatment because of anorexia and facial flushing. One patient was withdrawn after 8 weeks because of interruption of lisinopril therapy for a transurethral resection of the prostate, and one patient was lost to follow-up. No clinically significant haematological or biochemical changes were observed. The mean glomerular filtration rate was unchanged during the study. Proteinuria did not occur de novo, nor did established proteinuria increase. Thus lisinopril was well-tolerated and effective therapy in a group of elderly hypertensive patients.

Aged↗
PubMed1986

Intermittent protein-sparing fasting with abdominal belting.

In an attempt to minimize the weight regain that often follows effective weight reduction, a programme has been evaluated which involved the use of a nylon waist cord which could be readily tightened but not lengthened, during a regime of alternating periods of a liquid diet and a high-fibre natural diet combined with behavioural modification. Forty subjects completed the initial cycle of a liquid regime with an overall weight loss of 7.7 kg during the treatment period. Thirty-six of these subjects have been followed up for a mean of 12 months after the completion of the treatment programme. Five subjects are difficult to categorize having worn the cord for some but not all of this time. Fourteen have continued to wear the waist cord throughout and have achieved a further mean weight loss of 4.8 kg. This differs significantly from the 17 subjects who cut off the cord and who have regained a mean of 6.6 kg. The results suggest that an adjustable waist cord is a valuable aid to achieving successful and permanent weight reduction in some subjects.

Adult↗