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Biomedical subjects

Greg Cable

Publications and source records attributed to Greg Cable.

5 recordsLinked to original sources
PubMed2003

Effect of lunar cycle on temporal variation in cardiopulmonary arrest in seven emergency departments during 11 years.

OBJECTIVE: To determine the effect of the phase of the full and new moon on the variation in the number of daily cardiopulmonary resuscitations. DESIGN: A retrospective analysis of a computerized billing database of emergency department visits in a cohort of seven northern New Jersey (USA) emergency departments. PARTICIPANTS: Consecutive patients seen by emergency department physicians over an 11-year period (1 January 1988 to 31 December 1998). We determined the timing of full and new moon days from the National Oceanographic and Aeronautic Administration website. INTERVENTIONS: Time series regression estimated the independent effect of full and new moon days on the daily variation in cardiopulmonary resuscitations. Tests of statistical significance were made at alpha=0.05. RESULTS: A total of 2 370 233 emergency department visits were made during the 4018-day period of study. A total of 6827 had an emergency department diagnosis of cardiopulmonary resuscitation. We found no significant difference in the occurrence of cardiopulmonary resuscitations during the full moon (P=0.97). On average there were 6.5% fewer cardiopulmonary resuscitations during new moon days (P=0.02; 95% confidence interval 1.3-11.7%). CONCLUSION: Contrary to the traditional belief that more cardiopulmonary resuscitations occur during the full moon, we were unable to identify a significant effect during full moon days. However, there were on average 6.5% fewer cardiopulmonary resuscitations during new moon days than other days.

Cardiopulmonary Resuscitation↗
PubMed2002

Calendar patterns in the occurrence of cardiac arrest.

Our objective was to determine whether monthly and daily patterns existed in cardiac arrests in a 7 emergency department (ED) cohorts in New Jersey. We conducted a retrospective analysis of a computerized database over an 11-year period containing 2,370,233 patient visits and 6,827 nontraumatic cardiac arrests. Time-series regression revealed colder months having more cardiac arrests, especially for patients >or=65 years of age. In that age group, December and March were highest with 17% more (P =.002) than the average of nonsignificant months. August was the lowest with 19% (P =.001) fewer cardiac arrests. Day-of-week variation was found only for patients <65 years of age. Saturdays and Mondays had more arrests than nonsignificant days, 15% (P <.0001) and 9% (P =.01), respectively. We conclude that there are monthly and daily patterns in cardiac arrests, with more arrests in the colder months for those >or=65 years of age, and more for ages <65 on Saturdays and Mondays.

Age Factors↗
PubMed2002

Income, race, and preventable hospitalizations: a small area analysis in New Jersey.

This research examines the effect of income, race, and cultural factors on preventable hospitalizations, using age and sex-adjusted preventable admissions from 53 contiguous zip codes in New Jersey from 1993 to 1995. Low income was strongly associated with high rates of preventable hospitalization in the study zip codes. Income is likely a proxy for education level, barriers to accessing primary care, and health insurance. A floor effect of income levels was present that may reflect a natural level of preventable hospitalization not affected by income, education, or health insurance status. An independent relationship found between nonwhite race and high preventable hospitalization may be in part the result of delays in seeking care affected by antecedent cultural factors. Removing financial barriers is critical but may be insufficient for reducing preventable hospitalizations if other barriers are not also addressed.

Adolescent↗
PubMedDate not supplied

Meta-analysis of prostate-specific antigen and digital rectal examination as screening tests for prostate carcinoma.

BACKGROUND: Physicians commonly screen for prostate cancer by using prostate-specific antigen (PSA) and digital rectal examination (DRE). The usefulness of these screening mechanisms is not well established, however. A meta-analysis of PSA and DRE to detect prostate carcinoma was conducted with a focus on sensitivity, specificity, and positive predictive value. METHODS: A literature search of OVID database (1966 to November 1999) using the medical subject headings "prostate-specific antigen" and "mass screening," as well as "prostate carcinoma," was performed. Thirteen articles were selected for the meta-analysis in this study. Most studies included asymptomatic men older than 50 years from various countries. Pooled results were calculated from the individual reports for sensitivity, specificity, and positive predictive value for PSA and DRE based on biopsy result as the reference standard. RESULTS: The overall detection rate of prostate carcinoma was 1.8% based on a positive biopsy. Of the prostate carcinoma detected, 83.4% was localized. The pooled sensitivity, specificity, and positive predictive value for PSA were 72.1%, 93.2% and 25.1%, respectively; and for DRE were 53.2%, 83.6% and 17.8%, respectively. CONCLUSIONS: There were two major outcomes of this meta-analysis. One was the potential for detecting early-stage prostate cancer with these screening tests, because 83.4% of total cancers detected were localized. The second important outcome was that the overall sensitivity, specificity, and positive predictive value for PSA were higher than those for DRE when used as a screening tool to detect prostate cancer. When a patient has abnormal findings using PSA and DRE, the chance of cancer is 1 in 4 or 5. Conversely, when findings from PSA and DRE are normal, the chance of missing a cancer is about 10%.

Adult↗