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At least 1,243 records · Page 69Linked to original sources
PubMed1990

Practical management of atrial fibrillation.

Management of atrial fibrillation includes assessing the need for rate control, identifying underlying conditions, and performing cardioversion or instituting long-term medical therapy. Elective cardioversion should be strongly considered for every patient, chiefly to decrease the incidence of embolic stroke. Patients who remain in chronic atrial fibrillation require attention to rate control; digoxin (Lanoxin) alone may be a poor choice if they are vigorous and active. Many subgroups of patients benefit from long-term anticoagulation.

Acute Disease↗
PubMed1989

Costs of existing and recommended manure management practices for house fly and stable fly (Diptera: Muscidae) control on dairy farms.

Costs of fly control practices were estimated for 26 New York and Maryland dairy farms. Objectives were to characterize existing practices, compare them with the cost of more frequent and complete manure removal to reduce fly breeding, and to compare costs of manure removal and insecticide application. Information was collected in scouting visits and personal interviews of farm operators. Equipment, labor, and bedding costs were included for manure removal. Insecticide application costs included chemicals and labor for application. A typical farm with a stanchion barn had manure removal costs of $0.348 per cow per day. Recommended changes would increase costs by $0.016-0.033 per cow per day. Insecticide costs averaged $0.021 per cow per day. It may be possible to eliminate many of the insecticide applications on the farms by using the recommended 7-d manure removal practice. Even if insecticides are not eliminated entirely, increased manure removal costs would be offset by some reduction in insecticide cost. This also would have the additional benefit of greatly slowing the development of insecticide resistance by the flies.

Animals↗
PubMed2000

Impact of current management practices on early and late death in more than 500 consecutive cardiac transplant recipients.

OBJECTIVE: To study risk factors for early and late death after heart transplantation in the current era. SUMMARY BACKGROUND DATA: The current cardiac transplant population differs from earlier periods in that an increasing number of sicker patients, such as those with ventricular assist device (LVAD) support, prior cardiac allotransplantation, and pulmonary hypertension, are undergoing transplantation. In addition, sensitized patients constitute a greater proportion of the transplanted population. Emphasis has been placed on therapies to prevent early graft loss, such as the use of nitric oxide and improved immunosuppression, in addition to newer therapies. METHODS: Five hundred thirty-six patients undergoing heart transplantation between 1993 and 1999 at a single center were evaluated (464 adults and 72 children; 109 had received prior LVAD support and 24 underwent retransplantation). The mean patient age at transplantation was 44.9 years. Logistic regression and Cox proportional hazard models were used to evaluate the following risk factors on survival: donor and recipient demographics, ischemic time, LVAD, retransplantation, pretransplant pulmonary vascular resistance, and immunologic variables (ABO, HLA matching, and pretransplant anti-HLA antibodies). RESULTS: The rate of early death (less than 30 days) was 8.5% in adults and 8.8% in children. The actuarial survival rate of the 536 patients was 83%, 77%, and 71% at 1, 3, and 5 years, respectively, by Kaplan Meier analysis. Risk factors adversely affecting survival included the year of transplant, donor age, and donor-recipient gender mismatching. Neither early nor late death was influenced by elevated pulmonary vascular resistance, sensitization, prior LVAD support, or prior cardiac allotransplantation. CONCLUSIONS: Previously identified risk factors did not adversely affect short- or long-term survival of heart transplant recipients in the current era. The steady improvement in survival during this period argues that advances in transplantation have offset the increasing acuity of transplant recipients.

Adolescent↗
PubMed1994

Dystonic storms: a practical management problem.

On rare occasions, torsion dystonia can rapidly worsen and produce life-threatening symptoms. We present reports on two children who had generalized dystonia and who demonstrate the management difficulties of "dystonic storms."

Child↗
PubMed1980

Practical management aspects of intraoperative arrhythmias: the anesthesiologist's viewpoint.

A wide range of cardiac arrhythmias may be observed during anesthesia and intraoperatively and they usually have a multifactorial origin. A broad understanding of the various arrhythmogenic factors is important in the safe and effective treatment of these rhythm disorders. A large number of intraoperative arrhythmias can be successfully managed by expectant observation and elimination of the frequently implicated stimuli, e.g., hypercapnia, anesthetic overdose, hypoxia, excessive sympathetic activity, or surgical stimulation. Certain arrhythmias, however, depending on their intrinsic prognosis and the hemodynamic state of the patient, require immediate treatment with antiarrhythmic drugs or direct current countershock, or both.

Adolescent↗
PubMed2006

Autism spectrum disorder screening and management practices among general pediatric providers.

It is unclear to what extent general developmental/behavioral assessments are performed, if screening for autism spectrum disorders (ASDs) is being conducted, and what the barriers to providing such assessments are in routine pediatric practice. Therefore, this study examines (1) the factors influencing the use of general developmental and autism-specific screening tools in primary care pediatric practice, (2) the barriers to providing these assessments, and (3) pediatricians' beliefs regarding ASD prevalence. A cross-sectional survey was mailed in June 2004 to a 60% (n = 1119) random sample of Maryland and Delaware licensed pediatricians. In August 2004, a second mailing was sent to non-respondents. A total of 471 (42%) of the surveys were returned, and of those, 255 (54%) who practiced in general primary care were eligible. The sample was 47% male, 69% had more than 14 years' experience, 71% were in private practices, and 56% had fewer than 10 ASD patients. Most (82%) routinely screened for general developmental delays, but only 8% screened for ASD. The main reasons reported for not screening for ASD were lack of familiarity with tools (62%), referred to a specialist (47%), or not enough time (32%). Most specialist referrals (77%) were to a developmental pediatrician. Most pediatricians (71%) believed that ASD prevalence has increased, and nearly all attributed this to changes in diagnostic criteria and treatment. Service system limitations must be overcome to increase awareness and familiarity with screening tools, provide sufficient time and resources, improve screening, and enhance provider education.

Adult↗