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G H Miller

Publications and source records attributed to G H Miller.

147 records · Page 9Linked to original sources

The life expectancy of nonsmoking men and women.

The pronounced difference in life expectancy between men and women in the United States and other industrialized countries has been attributed to a variety of causes, among them, differential rates of cigarette smoking. A study was undertaken to eliminate the confounding factors of imprecision in the taking of smoking histories and exaggeration of early traumatic deaths in life expectancy calculations. Survey data were collected on the lifetime smoking habits of adults in Erie County, Pa., as of 1972-74. In the survey interviews, careful distinctions were made between respondents who had formerly smoked and respondents who had never smoked. The survey data were combined with data collected from surviving relatives about the smoking habits of people who had died in Erie County during the years 1972-74. After deaths attributable to traumatic causes (accidents, suicides, and homicides) were removed, life tables were calculated for male and female nonsmokers over age 30. The resulting life expectancy figures for nonsmoking men and women of parallel age were virtually identical. Thus, differential rates of cigarette smoking are apparently the overwhelming cause for the male-female longevity difference. Actuarial tables should be divided by smoking behavior to reflect this finding. The results of the study suggest that the present longevity difference between men and women will disappear.

Adult↗

Office single puncture laparoscopy sterilization with local anesthesia.

BACKGROUND AND OBJECTIVES: Recently there has been a renewed interest in office based laparoscopy sterilization utilizing local anesthesia with conscious intravenous sedation. The safety of performing the procedure outside of a hospital environment has been questioned. The author attempts to determine the incidence of major complications with a review of the literature and a retrospective chart review of his personal cases. METHODS: During the period from 1971 to 1995, the author performed 1,753 laparoscopic procedures, utilizing local anesthesia in 1,562 cases and general anesthesia in the remainder. The focus of this chart study is the 1,190 laparoscopy sterilization cases performed in an office exam room setting, utilizing local anesthesia and conscious intravenous analgesia. Conventional 10 mm single puncture laparoscopy equipment was used. Major complications were defined as requiring laparotomy, blood transfusion, cardiopulmonary resuscitation, or emergency transfer to the hospital. RESULTS: The author's series contained one major complication, which was easily handled in the office environment. A review of the literature, including the author's series, revealed a major complication incidence of 5 out of 20,568 cases reviewed. None of these five complications would have required immediate laparotomy or blood transfusion to prevent a fatality. CONCLUSION: The author proposes that there is no documented evidence that office laparoscopy places the patient at increased risk for a life-threatening complication and should be considered by experienced gynecologic laparoscopists who are interested in cost containment.

Ambulatory Surgical Procedures↗