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Biomedical subjects

E F Luckstead

Publications and source records attributed to E F Luckstead.

18 recordsLinked to original sources
PubMed2000

Improved outcomes for hospitalized asthmatic children using a clinical pathway.

BACKGROUND: Although asthma clinical pathways are used with increasing frequency, few controlled studies have evaluated the clinical and cost effectiveness of these pathways. OBJECTIVE: To evaluate the effect of an inpatient asthma clinical pathway on cost and quality of care for children with asthma. METHODS: One hundred forty-nine children were treated for status asthmaticus using an asthma clinical pathway in a children's hospital between September and December 1997. Thirty-four of 149 children treated with the clinical pathway were randomly selected. A retrospective cohort control group of non-pathway patients (N = 34) was matched with each pathway patient by age, race, gender, co-morbidities, asthma severity score, ICU admission, and time of year admitted. Differences between the two groups in length of stay, total costs, readmission rate, inpatient management, and discharge medications were compared. RESULTS: Length of stay was significantly lower in the clinical pathway group compared with the control group (36 hours versus 71 hours, P < .001) and total costs decreased significantly ($1685 versus $2829, P < .001) as a result of the pathway. Asthmatic children on the clinical pathway were significantly more likely than the control group to complete asthma teaching while hospitalized (65% versus 18%, P < .001), to be discharged with a prescription for a controller medication (88% versus 53%, P < .01), and to have a peak flow meter (57% versus 23%, P < .05) and a spacer device (100% versus 71%, P < .001) for home use. CONCLUSION: Implementation of this inpatient clinical pathway led to a decrease in length of stay and a reduction in total cost while improving quality of care for hospitalized asthmatic children.

Asthma↗
PubMed2000

Sport participation, risk taking, and health risk behaviors.

Adolescents participate in sports for a variety of reasons. Some seem to enjoy participating in what some might consider very-high-risk or "extreme" sports activities. For some adolescents risk taking becomes pervasive and can be detrimental to normal health and development. The majority of adolescents will do well in the context of athletics, and the many positive benefits of regular physical activity and sports participation should be appropriately emphasized. However, a subset of adolescents may be at greater risk for adverse consequences. This article reviews the reasons for participation and attrition from sports, the phenomenon of thrill seeking in sports, certain risk-taking behaviors of athletes, and studies comparing health risk behaviors in athletes and non-athletes.

Adolescent↗
PubMed1998

Cardiovascular evaluation of the young athlete.

Young athletes with possible cardiac problems may require medical advice, sports medicine information, and treatment before a clinician can sanction sports participation. In addition, the potential medical liability of cardiac abnormalities makes the preparticipation cardiac evaluation a top priority. The author emphasizes the importance of obtaining a thorough cardiac history and performing a cardiac-specific physical examination, which may include diagnostic tests such as the treadmill and color flow Doppler echocardiography. Common cardiac referral complaints such as chest pain, murmurs, and syncope are also reviewed.

Adolescent↗
PubMed1983

Hepatic hemangiomatosis of infancy.

A 2-month-old female infant with congestive heart failure secondary to hepatic hemangiomatosis was treated with prednisone for five weeks without clinical improvement. She then underwent acute cardiac decompensation and required assisted ventilation. The hepatic artery was ligated to decrease the blood supply to the hemangiomata. Although the engorged liver softened dramatically, she continued to require mechanical ventilation for cardiac failure. Ten days postoperatively, she underwent digitalization with significant improvement in cardiac function, and she was then weaned from the respirator. Although, at 2 1/2 years of age, her liver has remained somewhat enlarged, her cardiovascular function has been normal. Our experience indicates that hepatic hemangiomatosis can be successfully treated via hepatic artery ligation and that cardiotonic measures might sometimes be required for recovery from coexisting congestive heart failure.

Angiomatosis↗
PubMed1982

Sudden death in sports.

I have stressed the known medical and environmental factors associated with unexpected, sudden death in sports in children, and I have recommended restrictions or environmental alterations to prevent sudden death associated with an individual sport. Medical problems such as cardiomyopathies, posterior mitral valve leaflet syndrome, and underlying congenital heart problems have been related, when possible, to their role in sudden deaths related to sport. I have emphasized the abnormalities of hypertrophic cardiomyopathy, Marfan's syndrome, and the need to monitor constantly the medical, environmental, and safety factors for all sports in which our youth now actively participate.

Adolescent↗
PubMed1980

Hemophilus influenzae purulent pericarditis in children: diagnostic and therapeutic considerations.

Purulent pericarditis is an unusual complication of infection in infancy and has been associated with an extremely high mortality rate. Early diagnosis followed by combined antibiotic therapy and surgical drainage of the pericardium has markedly improved survival. Between APril, 1975, and February, 1979, nine patients with purulent pericarditis secondary to Hemophilus influenzae type B were treated at the Oklahoma Children's Memorial Hospital. In every case signs and symptoms of congestive heart failure were present, and a pericardial effusion was demonstrated by echocardiography and confirmed by pericardiocentesis. The organism was identified with countercurrent immunoelectrophoresis and antibiotic sensitivity determined by rapid beta lactamase assay. All patients were treated with a combination of parenteral antibiotics and open surgical drainage of the pericardium. There were no deaths and all patients demonstrated marked improvement following operation. Follow-up echocardiography revealed no evidence of pericardial effusion or signs of constriction in any patient.

Anti-Bacterial Agents↗
PubMed1979

Echocardiographic findings in a fatal case of Kawasaki's disease.

Kawasaki's disease or mucocutaneous lymph node syndrome is being diagnosed with increasing freqency in this country. Although death is a rare complication coronary arteritis with associated myocardial changes is common. Echocardiography is proposed as a non-invasive study that may aid in the early detection of cardiac involvement.

Child, Preschool↗