Search PubMed⌕ Search

Biomedical subjects

S Cullen

Publications and source records attributed to S Cullen.

50 records · Page 3Linked to original sources
PubMed1991

Risk factors for arrhythmia and death after Mustard operation for simple transposition of the great arteries.

From 1965 to 1980, 249 consecutive patients underwent a Mustard procedure for simple transposition of the great arteries. Hospital mortality was 23 of 249 (9.2%); follow-up for 24 years (mean, 11.7 +/- 6.1 yr) revealed 50 of 249 (20%) late deaths, of which seven were noncardiac, six were in the hospital, and 37 were sudden (27 patients with poor hemodynamics and 10 unexplained). Actuarial survival after 1, 10, and 20 years was 85, 75, and 67%. The instantaneous risk of death decreased rapidly after surgery but showed a second peak from 8 to 15 years postoperation. When last seen 87% were in New York Heart Association (NYHA) class I; 69% had sinus rhythm, 20% nodal rhythm, 10% atrial flutter, and 1% paced. Survival in uninterrupted sinus rhythm after 5, 10, and 20 years was 75, 62, and 47%. Nodal rhythm detected by annual ECG occurred in 69 patients. Excluding the early experience, the risk of loss of sinus rhythm was constant in time and constant throughout the experience (2.4%/yr). Atrial flutter was observed in 36 patients. Occurrence of atrial flutter was limited to two discrete surgical periods: the first operations (26 with atrial flutter of the first 50) and an ill-defined period in the middle of the experience. Patients not operated on during these two periods were very unlikely to develop atrial flutter (one of 104, p less than 0.001). As for death, the hazard function showed a bimodal curve, the second peak appearing earlier from 5 to 11 years. If nodal rhythm was noted on the yearly routine ECG, the risk for developing subsequent atrial flutter increased by a factor of 2.1 (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Actuarial Analysis↗
PubMed1990

Isolated pulmonary vein atresia.

Two patients with isolated atresia of the pulmonary veins are described. One patient presented with haemoptysis and the other with recurrent unilateral chest infections. The diagnosis was confirmed in both instances by cardiac catheterisation and pulmonary angiography. One patient died one year after the diagnosis was made and the second child has been stable during a follow up period of three years.

Blood Pressure↗
PubMed1990

Calcitropic hormone levels in polynesians: evidence against their role in interracial differences in bone mass.

Blacks are known to have a higher bone mass than whites and have recently been found to have significantly different levels of calcitropic hormones and other biochemical indices of calcium metabolism. To assess the possible significance of these biochemical differences to interracial differences in bone mass, we have undertaken an assessment of indices of calcium metabolism in Polynesian subjects, since they also have a higher bone mass than whites. Serum concentrations of 25-hydroxyvitamin D were slightly lower in Polynesians than in whites (65 +/- 5 vs. 95 +/- 10 nmol/L; P less than 0.02), but there were no differences between the groups in serum levels of calcium (total and ionized), phosphate, magnesium, 1,25-dihydroxyvitamin D, PTH, calcitonin, alkaline phosphatase activity, and bone gla-protein. Furthermore, urinary excretion of hydroxyproline, calcium, phosphate, magnesium, sodium, and potassium and the tubular maximum for the reabsorption of phosphate were not different between whites and Polynesians. Intestinal strontium absorption was similar in the two groups. In contrast, distal forearm bone mineral content was higher in Polynesians (P less than 0.01) and midupper arm muscle area was also increased in this group (P less than 0.005). It is concluded that the higher bone mass of Polynesians cannot be attributed to alterations in the basal levels of calcitropic hormones, but may be related to their greater muscle mass. It is probable that the previously observed black-white differences in the vitamin D endocrine system are secondary to the effects of skin color on vitamin D synthesis and are not contributory to the lower bone mass of whites.

Adult↗
PubMed1989

Cardiovascular manifestations in Kawasaki disease.

Thirteen patients with Kawasaki disease were reviewed. The average age at presentation was 31 months (range: 6 weeks to 8 years). Mean follow up was 36 months, with a range of 5 to 53 months. Cardiovascular manifestations were present in 9 patients. These comprised pericarditis with myocarditis (2), pericardial effusion (4), coronary artery ectasia (3), coronary artery aneurysms (3), peripheral artery aneurysm (1) and peripheral vasculitis (1). Treatment consisted of aspirin alone in 11 and gammaglobulin with aspirin in 2 patients. One patient with coronary artery involvement died following a myocardial infarction. A large coronary artery aneurysm persists, 31 months after initial detection in another patient. Spontaneous resolution of the cardiovascular complications occurred in the remaining seven patients. The importance of clinical awareness and detailed evaluation and follow up of the cardiovascular system in Kawasaki disease is emphasised. There is also a need, however, to exclude other diagnoses which may have a similar clinical presentation.

Cardiovascular Diseases↗
PubMed1989

Paracetamol suppositories: a comparative study.

Paracetamol suppositories in two different bases were given to children who had fever after operations. Plasma concentrations and the effect on temperature were compared. There was a significant correlation between peak plasma concentrations and maximum drop in temperature. A lipophilic base produced better results than a hydrophilic base.

Acetaminophen↗
PubMed1989

Atlantoaxial instability in Down's syndrome: clinical and radiological screening.

One hundred and thirty children with Down's syndrome were screened for the presence of atlantoaxial instability, using both clinical examination and radiographs of the cervical spine taken in flexion and hyperextension views. Seven children were found to have radiological evidence of atlantoaxial instability, with an atlanto-dens interval greater than 5.0 mm in one or all positions. Although a full clinical history was obtained from the attending parent and each child underwent a complete neurological examination, there were no factors detected which differentiated between those with radiological evidence of atlantoaxial instability and those with a normal atlantodens distance. It is recommended that children with Down's syndrome be screened twice, at the ages of 5-10 years and at 15 years.

Adolescent↗
PubMed1989

Bacterial endocarditis and lymphadenopathy mimicking Kawasaki disease.

Two children whose illness initially fulfilled the clinical criteria for the diagnosis of Kawasaki disease were both subsequently found to have acute bacterial endocarditis and one child had a disseminated non-Hodgkins lymphoma. We describe their clinical course and emphasize the importance of the exclusion of other diagnosis as well as strict adherence to the accepted diagnostic criteria of Kawasaki disease.

Child↗
PubMedDate not supplied

A comparative study of clarithromycin modified release and amoxicillin/clavulanic acid in the treatment of acute exacerbation of chronic bronchitis.

This phase III, investigator-blind, randomized, parallel-group study compared the efficacy and tolerability of clarithromycin modified release (MR) with those of amoxicillin/clavulanic acid in 250 adult outpatients with acute exacerbationof chronic bronchitis (AECB). Patients received either clarithromycin MR 500 mg once daily or amoxicillin/clavulanic acid 500 mg/125 mg three times daily for 7 days. Primary endpoints were sponsor-defined clinical response and pathogen outcome at the end of treatment. Secondary endpoints were sponsor-defined clinical response and pathogen outcome at study end, investigator-defined clinical response at end of treatment and end of study, resolution or improvement of signs and symptoms, eradication of baseline pathogens, serologic outcome for atypical pathogens, and occurrence of reinfection and superinfection. Adverse events and compliance were also evaluated. Clinical and bacteriologic outcomes with both treatments for all endpoints were statistically equivalent, as were total adverse events, although the incidences of digestive disturbances (13% vs 4%) and discontinuations due to adverse events (8 vs 2 patients; P < or =.05) were significantly higher with amoxicillin/clavulanic acid. Ninety-five percent of patients receiving clarithromycin MR and 80% receiving amoxicillin/clavulanic acid were 100% compliant with medication (P < or =.05). Clarithromycin MR and amoxicillin/clavulanic acid are both well tolerated and effective as therapy for AECB; however, clarithromycin produced fewer side effects and discontinuations and higher compliance rates.

Amoxicillin-Potassium Clavulanate Combination↗
PubMedDate not supplied

Donor organ preservation fluids differ in their effect on endothelial cell function.

Successful organ transplantation depends on adequate preservation of cellular function. We tested the effect of four commonly used donor organ preservation fluids on the ability of cultured bovine pulmonary artery endothelial cells to release endothelium-derived relaxing factor (EDRF). Columns of endothelial cells grown on microcarrier beads were exposed to either University of Wisconsin (Belzer's) solution, Marshall's preservation fluid, Euro-Collins solution, or a blood-based preservation fluid at 4 degrees C for 6 hours, and then to Krebs-Henseleit buffer at 37 degrees C for 1 hour. They were then stimulated with boluses of bradykinin, and the EDRF released was detected by bioassay. The release of EDRF from endothelial cells previously exposed to a preservation fluid was compared with the release of EDRF from control columns of cells perfused throughout at 37 degrees C with Krebs-Henseleit buffer. Previous exposure to any of the three non-blood-based preservation fluids did not attenuate bradykinin-stimulated EDRF release. By contrast, previous perfusion with the blood-based solution completely inhibited EDRF release (p less than 0.01, ANOVA), an effect attributable to the acidity of the solution. Donor organ preservation fluids differ in their effect on endothelial cell function, and this has important implications for lung and for other organ transplantation.

Adenosine↗