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At least 73 records · Page 4Linked to original sources
PubMed1990

Serologic survey for Borrelia burgdorferi antibody in horses referred to a mid-Atlantic veterinary teaching hospital.

Blood samples obtained from 13 of 100 (13%) and 6 of 91 (7%) horses at the George D. Widener Hospital for Large Animals in the months of June and October, respectively, had antibody to Borrelia burgdorferi as determined by ELISA. Horses from the states of New York, Maryland, Delaware, New Jersey, and Pennsylvania were seropositive for B burgdorferi. The frequency of antibody response in horses from New Jersey was greater (P less than 0.05) than the frequency of antibody response in horses from Pennsylvania or that of horses from the other states combined. Statistically significant difference was not found when a comparison was made between horses with serotiter and open diagnosis of neurologic or musculoskeletal disease and horses with negative serotest results and open diagnosis of neurologic or musculoskeletal disease.

Animals↗
PubMedDate not supplied

Impact of divergent evaluations by physicians and patients of patients' complaints.

Physicians' estimates of patients' anxiety, discomfort or pain, and activity limitation were compared with reports by their patients on the same dimensions. The data were collected as part of a series of quality assessment studies at a prepaid group practice serving 19,000 people in a Mid-Atlantic metropolitan area. Analysis of the data showed that physicians underestimated the three dimensions 35 percent of the time and that activity limitation was the dimension most often underestimated. Patients whose physicians correctly estimated their discomfort or pain were more likely to receive prescriptions than patients whose physicians underestimated their discomfort or pain. Patients whose physicians underestimated their activity limitation were most likely to report dissatisfaction with the treatment given. The results are consistent with a growing body of evidence suggesting that physicians who show concern about their patients and a desire to understand their problems establish better therapeutic relationships.

Adult↗
PubMedDate not supplied

Ambulatory care in the community.

To document the volume and kinds of ambulatory care, particularly primary care, being provided in a medically self-contained community, a survey was conducted in a county in a Middle Atlantic State during the summer of 1974 at all sites where physicians provided ambulatory care. These sites included not only physicians' offices, but also the emergency room, public health clinics, and physician-patient telephone encounters. Primary care was found to constitute 77 percent of all ambulatory care in the county and to account for 96 percent of all visits to primary care physicians. It also accounted for more than 50 percent of the visits to all physicians except the surgical subspecialists. Most of the primary care visits were for common disorders, common procedures, and common preventive measures. Distinct patterns were observed in the primary care morbidity treated by primary care physicians and that treated by specialists--patterns that seemed appropriate for those practices. The specialties of the physicians who were available to the population may have influenced morbidity patterns in the community surveyed. The primary care provided by primary care specialists appeared to differ in some functional aspects from that provided by other specialists.

Adult↗
PubMed1989

The Mid-Atlantic Oncology Program's comparison of two data collection methods.

The Mid-Atlantic Oncology Program (MAOP) compared clinical trial data collected by circuit riding data managers (CDMs) from the MAOP statistical center with data collected by local data managers (LDMs) from clinics and practices, the latter being the standard data capture method in cancer clinical trials. LDMs and CDMs filled out identical study forms, using the same patient charts, for randomly selected patients on MAOP protocols. All coded answers on the forms were compared by one of the authors (DJ) and discrepant items were resolved in a blinded manner by the local MAOP physician acting as the principal investigator (PI). Thirty-three patient charts were reviewed with 53 pairs of forms completed and 1023 pairs of codes compared. A total of 129 (13%) pairs of codes were considered discrepant. Of the 100 discrepancies resolved (29 items were answered differently by the CDM, LDM, and PI) the PI's answers matched 66 of 100 codes as recorded by the CDMs and 34 of 100 codes as recorded by the LDMs. This results in chi 2 = 9.61 (p less than 0.005), demonstrating a significant difference between the frequency with which the PI's answers matched data collected by the CDMs and LDMs. It was also determined that CDMs consistently coded toxicities as more severe than did LDMs and were more often correct. Given the results of this study, CDMs should be considered an acceptable alternative to LDMs in the context of regional programs.

Bias↗
PubMed1989

National surveillance of Lyme disease, 1987-1988.

In 1987 and 1988, 6876 Lyme disease cases from 43 states were reported to the Centers for Disease Control. The 4507 cases reported in 1988 was nearly double the case number reported in 1987, and ninefold the number reported in 1982, when a systematic system of national surveillance was established. The average annual incidence of reported Lyme disease in the United States in 1987-1988 was 1.4/100,000. New York led the nation in reported cases in 1988 with 57% of the cases reported nationally. Eight states, New York, New Jersey, Pennsylvania, Connecticut, Massachusetts, Rhode Island, Wisconsin, and Minnesota, reported 92% of the nation's cases. The state reporting the highest incidence rate in 1987-88 was Rhode Island, with 9.9 cases/100,000. Regionally, incidence rates were highest in Northeastern and Mid-Atlantic states, intermediate in North Central and Pacific states, lower in the Southeast, and lowest in the Great Plains and Mountains states. The seven remaining states in which Lyme disease has not been transmitted all lie west of the 100th meridian.

Humans↗