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Biomedical subjects

D F Phillips

Publications and source records attributed to D F Phillips.

At least 55 records · Page 3Linked to original sources
PubMed1983

Growing pains.

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Centers for Disease Control and Prevention, U.S.↗
PubMed1981

Coping with change.

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Contract Services↗
PubMed1980

Late survival following use of intraaortic balloon pump in revascularization operations.

The early and late results of intraaortic balloon pump (IABP) support in 197 patients with pure myocardial revascularization were analyzed. Group I, 61 patients, had IABP support initiated preoperatively; Group II, 99 patients, had IABP support in the operating room because of inability to be weaned from bypass; and Group III, 37 patients, had support instituted for persistent low cardiac output state in the postoperative period. The early results showed that 73% were discharged from the hospital and that delayed use of the IABP was associated with a high mortality and high rate of perioperative myocardial infarction. When the results between men and women were compared, no statistical difference was noted. After a mean follow-up of 18 months, there were 9 late deaths. Three were due to noncardiac causes. The two-year cardiac actuarial survival for the hospital survivors was 96% and all three groups had uniformly good symptomatic relief. After hospital discharge, the late results of patients who required use of the IABP in conjunction with pure myocardial revascularization were the same as for patients who did not require IABP support.

Assisted Circulation↗
PubMed1980

M-mode echocardiography in anteroseptal myocardial infarction. Lack of sensitivity.

Eighteen patients with documented anteroseptal myocardial infarction (ASMI) were investigated with both cardiac catheterization and M-mode echocardiography. All had greater than 75% occlusion of the left anterior descending artery (LAD), proximal to the first septal perforator in 12, and distal to it in 6; 17 of 18 had abnormal septal motion by angiography. In contrast, echocardiography revealed abnormal septal motion in only 5 of 18; two others had diminished septal wall thickness in relation to posterior ventricular wall. The presence of these echocardiographic signs was not dependent either on relation of stenosis to septal perforators or on presence of septal collaterals. Although abnormal septal motion by M-mode echocardiography may indicate ASMI, normal motion does not exclude it nor does it help localize stenosis of the LAD.

Adult↗
PubMed1980

Nosocomial infections: a glimpse into the '80s.

The 1970s saw many changes in the way physicians dealt with infections. For example, greater emphasis was placed on specific risk environments rather than on the hospital's general physical environment and significant progress was made in controlling diseases such as post-transfusion hepatitis. Many challenges remain for the '80s, however, such as development of a data base to determine what infection control practices are the most cost-effective and development of a model for describing and measuring infection risk.

Cost-Benefit Analysis↗
PubMed1979

Routine coronary angiography prior to elective aortic reconstruction: results of selective myocardial revascularization in patients with peripheral vascular disease.

Routine coronary angiography to determine the prevalence of severe coronary artery disease (CAD) has been recommended to all patients under consideration for elective peripheral vascular reconstruction at the Cleveland (Ohio) Clinic since April 1978. Those found to have severe, correctable CAD have been advised to undergo myocardial revascularization prior to performance of elective peripheral vascular operations. Forty-one of the 68 patients with abdominal aortic aneurysms (AAA) and 26 of the 71 patients with aortoiliac occlusive arterial disease (AI) had clinical evidence of CAD; coronary angiography demonstrated severe, correctable CAD in 23 patients with AAA and in 14 patients with AI. Twenty-seven patients with AAA and 45 patients with AI had no clinical evidence of CAD; severe, correctable CAD was found in six patients with AAA and in six patients with AI. Ninety-six patients, including 26 who had staged cardiac procedures performed, have had elective aortic reconstruction, with one operative death.

Adult↗
PubMed1978

Curbing the nation's appetite: the case for controlling demand.

For too long, controls have been placed on the costs of services, the construction of health care facilities, the numbers and kinds of providers, and the health insurance industry with no concomitant limits being set on the rising demand for capital-intensive and specialized services. If we are to avoid having a debilitated health care system that will be unable to respond to community needs, the author says, a more balanced approach in controlling supply and demand will have to be sought. He discusses some of the conceptual, technical, and operational problems that must be addressed immediately if these actions are to be successful.

Delivery of Health Care↗
PubMed1978

The efficacy of CT: what the studies show.

Is computed tomography (CT) a diagnostic miracle or an expensive and unproven procedure? In the multitude of published studies, critics of CT demand controlled clinical trials, but thus far the efficacy of CT has been judged from clinical experience alone, and few studies have been done on the effect of CT on disease management and patient outcome.

Cost-Benefit Analysis↗
PubMed1977

Aortic valve replacement combined with myocardial revascularization. Late clinical results and survival of surgically-treated aortic valve patients with and without coronary artery disease.

From 1967 through 1973, 80 consecutive patients underwent simultaneous aortic valve replacement (AVR) and coronary bypass grafting. Fourteen (18%) experienced no angina pectoris and had no history or electrocardiographic evidence of coronary atherosclerosis. Seven of these 14 had severe multiple vessel disease. All operations were performed under normothermic conditions without coronary perfusion. Seven patients (9%) died during operation. Intra-operative myocardial infarction was documented in eight (10%). After a mean follow-up of 35 months, overall mortality was highest in aortic regurgitation patients [seven of 13 (54%)] compared to aortic stenosis [17 of 54 (31%)] (P less than 0.07), and mixed pathology [1 of 13 (8%)]. Thirty-one of 34 (91%) grafts in 25 patients were patent an average of 12 months postoperatively. After 42 months a 65% actuarial survival was found in the combined AVR and graft(s) series versus a 76% survival in 300 AVR patients proven by angiography not to have severe coronary atherosclerosis.

Adult↗
PubMed1977

Ventricular tachyarrhythmias following surgery for myocardial revascularization. A follow-up study.

Of 1,599 patients who underwent surgery for direct myocardial revascularization in 1973 at Cleveland Clinic Hospital, 19 patients (1.2 percent) developed primary ventricular fibrillation or ventricular tachycardia during the immediate postoperative period. Occurrence of postoperative ventricular tachyarrhythmias could not be predicted by assessment of preoperative symptoms or by evaluation of the extent of coronary artery disease and left ventricular function. There was no increase in early or late mortality or morbidity (including postoperative myocardial infarction) among patients who developed postoperative primary ventricular tachyarrhythmias.

Angina Pectoris↗