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Biomedical subjects

R G Talbot

Publications and source records attributed to R G Talbot.

14 recordsLinked to original sources
PubMed1984

Rheumatic fever and rheumatic heart disease in the Hamilton health district: I. An epidemiological survey.

The establishment of a computer based rheumatic fever register in the Hamilton health district is reported. The mean annual incidence of rheumatic fever over a five period in Maoris and non-Maoris 5-29 years of age was 88.0 and 9.3 per 100 000 respectively, with almost twice the recurrence rate in Maoris. The prevalence of rheumatic heart disease in Maoris and non-Maoris, 5-19 years of age, was 6.5 and 0.9 per 1000 respectively, Maoris being more likely to have severe or multiple valve lesions. Over a 10 year study of under 30 year olds, all 11 cardiac deaths occurred in Maoris. Twenty-seven out of 31 valve surgery cases were Maoris.

Adolescent↗
PubMed1984

Rheumatic fever and rheumatic heart disease in the Hamilton health district: II. Long term follow-up and secondary prophylaxis.

An analysis is made of follow-up and prophylaxis of 289 first attacks of acute rheumatic fever occurring over a ten year period in under 30 year olds in the Hamilton health district, New Zealand. Hospital clinics originally undertook to follow 84.4% of patients but after ten years, regular contact was maintained with 45% of this group while general practitioners maintained contact with 32% of their group. Fifty percent of all cases (and 77% of cases occurring in the past five years) are on regular benzathine penicillin usually administered by the district nursing service. Co-ordination with extramural services and the use of the computer based register as means of improving follow-up and prophylaxis are advocated, with more attention being given to defaulters.

Acute Disease↗
PubMed1976

[Frequency and prevention of ventricular arrhythmias after acute myocardial infarct].

In a controlled study using mexiletine and placebo, the incidence of ventricular arrhythmias after acute myocardial infarction (AMI) has been compared. The study covered 40 male patients who had sustained AMI and who in the first 48 h after onset of infarction had exhibited ventricular tachycardia, R on T-, multiform or close-coupled ventricular ectopic beats. Half of the patients were given either mexiletine (250 mg 8-hourly) or placebo. On the 4th and 10th day after onset of infarction a continuous 24-hour ECG was performed. 76% of the patients receiving placebo showed serious ventricular arrhythmias compared with 32% receiving mexiletine (p less than 0.05). These results demonstrate (1) the frequency of ventricular arrhythmias in a group of patients already at risk, and (2) the efficacy of an oral antiarrhythmic agent like mexiletine in the management of these rhythm disorders.

Arrhythmias, Cardiac↗
PubMed1976

Impaired Lignocaine metabolism in patients with myocardial infarction and cardiac failure.

Plasma concentrations of lignocaine were measured during and after infusion of lignocaine at 1.4 mg/min for 36-46 hours in 12 patients with myocardial infarction and one patient with cardiac failure due to uncontrolled ventricular tachycardia. In six patients without cardiac failure the plasma concentrations of lignocaine rose progressively during the infusion and the mean lignocaine half life was 4.3 hours compared with 1.4 hours in healthy subjects. Mean plasma lignocaine concentrations were significantly higher in seven patients with cardiac failure, and concentrations also rose during the infusion and the half life was considerably prolonged to 10.2 hours. Lignocaine concentrations rose rapidly to toxic levels when cardiogenic shock developed in one patient and did not fall when the infusion was stopped. The mean plasma antipyrine half life was moderately prolonged (19.4 hours) in a larger group of patients with myocardial infarction and cardiac failure but returned to normal during convalescence (13.2 hours). The metabolism of lignocaine is grossly abnormal in patients with cardiac failure and cardiogenic shock after myocardial infarction.

Adult↗
PubMed1976

Long-term treatment of ventricular arrhythmias with oral mexiletine.

Twenty-four patients with ventricular arrhythmias were treated with oral mexiletine for periods of from one to 16 months (total 10.4 patient-years). In 19 patients arrhythmias were satisfactorily controlled and plasma levels previously shown to be within the therapeutic range were maintained on an 8 hourly regimen. The drug was well tolerated in most patients and regular hematological and biochemical screening revealed no problems of toxicity.

Administration, Oral↗
PubMed1975

Comparison of procainamide and mexiletine in prevention of ventricular arrhythmias after acute myocardial infarction.

The incidence of ventricular arrhythmias after myocardial infarction has been compared in a controlled study of procainamide, mexiletine, and placebo. Sixty male patients who has sustained a myocardial infarction and had received lignocaine for ventricular tachycardia or ventricular ectopic beats which were R-on-T, multiform, or close-coupled took part. The efficacy of the drugs was evaluated by continuous 24-hour recordings of the electrocardiogram on the 4th and 10th days after admission to the study. Procainamide was given as 500 mg. 4-hourly and mexiletine as 250 mg. 8-hourly with corresponding placebo regimens for 12 days. 77% of patients receiving placebo showed serious ventricular rhythm disorders compared with 33% receiving antiarrhythmic therapy (p smaller than 0.05). Although only 35% of patients receiving procainamide achieved accepted therapeutic plasma concentrations compared with 95% of those receiving mexiletine, both drugs were equally effective antiarrhythmically. The only major adverse effect of therapy noted was development of a positive antinuclear factor in a procainamide-treated patient. These results demonstrate the efficacy of oral antiarrhythmic agents in the management of ventricular arrhythmias after acute myocardial infarction. Mexiletine has the advantage of less frequent administration and lower toxicity.

Administration, Oral↗
PubMed1975

Mexiletine.

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Administration, Oral↗