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Biomedical subjects

R P Hirsch

Publications and source records attributed to R P Hirsch.

9 recordsLinked to original sources
PubMed1992

Stroke in China (Sino-MONICA-Beijing study) 1984-1986.

We present here the results of the Sino-MONICA-Beijing stroke study based on 700,000 Beijing residents in 1984-1986. To compare incidence rates for stroke with other communities and countries, we adopted the criteria of the WHO Collaborative Study of 17 centers which used the same definition and methodology as was used in this study. Over the 3-year period of the study, 2,593 stroke events were registered in the 25- to 74-year age-group. The incidence rate for all strokes was 189.5/100,000 and the incidence rate for first strokes was 133.6/100,000. Men had a significantly higher incidence rate than women (all strokes 219.7/100,000 for male vs. 160.5/100,000 for female, OR = 1.32, 99% limits 1.19-1.46; first strokes 151.6/100,000 for male vs. 116.4/100,000 for female, OR = 1.25, 99% limits 1.11-1.42). In comparison with other studies, age-adjusted incidence rate of stroke in Beijing was higher than in other countries, especially for hemorrhagic stroke. The proportion of hemorrhagic stroke related to other types of stroke was also higher in Beijing. Further analysis of the cases confirmed by computerized tomography also supported this finding. Unlike the incidence rates, the 4-week case fatality rate for women, 39.5%, was higher than for men, 32.8%. This finding was confirmed by a multiple logistic analysis controlling for age (p less than 0.001) and for previous stroke (p less than 0.001). The adjusted sex difference is also significant (OR = 1.37, p less than 0.001). In addition, results showed that men had a higher hospitalization rate than women. More women than men were treated at home, possibly indicating better medical care for men.

Adult↗
PubMed1991

Report of an association between race and thyroid stimulating hormone level.

We examined the association between race and thyroid stimulating hormone (TSH) level in 809 consecutive Black or White adults tested for mild suspicion of hypothyroidism with a normal TSH result. The mean TSH level of Blacks was 0.4 (SE .053) mU/L lower than that for Whites after age and sex adjustment, race explaining 6.5 percent of the variation in TSH levels. A validation sample yield similar results. This finding supports the possibility that differences in thyroid function and/or regulation may be associated with race.

Black People↗
PubMed1989

Yield of hypothyroidism in symptomatic primary care patients.

Symptoms suggestive of hypothyroidism are common in primary care practice, but the yield of this disorder from symptom-based testing has not been adequately evaluated. We attempted to determine this yield and examine the effect of various patient factors on its magnitude. The records of 982 consecutive primary care health maintenance organization patients who had a thyroid-stimulating hormone (TSH) determination for suspicion of hypothyroidism were reviewed. Forty-two (4.3%) had an increased TSH concentration on initial testing, but only 17 (1.7%) had a TSH level 5 mU/L or more above normal. Abnormal thyroid examination results and white vs black race were independently associated with a TSH concentration 5 mU/L or more above normal. Female sex and age did not significantly affect the odds of an elevated TSH concentration. The yield of hypothyroidism from symptom-based testing in this setting was quite low. Although increasing age and female sex are both strong determinants of the risk of hypothyroidism in the general population, neither factor permitted risk stratification in symptom-based testing. The strong racial association noted was not anticipated and requires confirmation.

Adult↗
PubMed1978

Prevalence and distribution of Aeromonas hydrophila in the United States.

The abundance of Aeromonas hydrophila was measured in 147 natural aquatic habitats in 30 states and Puerto Rico. Viable cell counts were used to estimate density at all sites by using Rimler-Shotts medium, a differential presumptive medium for A. hydrophila. Temperature, pH, conductivity, salinity, and turbidity were measured simultaneously with water sample collection. The density of A. hydrophila was higher in lotic than in lentic systems. Saline systems had higher densities of A. hydrophila than did freshwater systems. A. hydrophila could not be isolated from extremely saline, thermal, or polluted waters, even though it was found over wide ranges of salinity, conductivity, temperature, pH, and turbidity. Of the water quality parameters measured, only conductivity was significantly regressed with density of A. hydrophila.

Aeromonas↗
PubMedDate not supplied

Non-returning patients: a survey of inactive patients in a suburban practice.

Maintaining an adequate patient volume is a new concern for primary care physicians. Retaining active patients may be as important as recruiting new patients. A mail survey was conducted using a random sample of patients not returning for care over a three-year period in a primary care office. Over half of the inactive patients were transient, never having established themselves with the practice. One third of regular attending inactive patients had changed physicians, whereas the others had simply not returned for care. Patients who had changed physicians were more likely users of emergency rooms or drop-in clinics, had more negative feelings while in physicians' offices, were less satisfied with their own present physicians, and had less positive attitudes toward physicians in general. Inactive patients who had not changed physicians were as satisfied with their own physicians and with physicians in general as the active patient control subjects, even though they used services infrequently, usually for acute care. Investigating transient patients and those who are inactive but remain with a practice would positively affect patient volume and would likely benefit these patients as well. Primary care physicians should survey their own inactive files before embarking on other marketing techniques.

Adult↗