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Biomedical subjects

B W Pace

Publications and source records attributed to B W Pace.

5 recordsLinked to original sources
PubMed1992

Intraoperative cholangiography revisited.

The charts of 1351 patients undergoing cholecystectomy at our institutions from 1985 through 1989 were reviewed retrospectively to evaluate the indications for and the success of intraoperative cholangiography. A total of 800 patients underwent intraoperative cholangiography. They were divided into two groups based on the absence (CR-) or presence (CR+) of clinical and/or operative criteria suggestive of the existence of common bile duct stones. Intraoperative cholangiography in CR- patients was of limited benefit, being negative (normal) in 95.7%, true-positive (abnormal) in 3.3%, and false-positive in 1%. False-positive intraoperative cholangiography resulted in unnecessary common bile duct explorations. Intraoperative cholangiography in CR+ patients proved useful, avoiding unnecessary common bile duct exploration in 55%. In those select CR+ patients with palpable common bile duct stones or cholangitis, little additional information was gained by the intraoperative cholangiography. We conclude that routine screening intraoperative cholangiography in CR- patients be reconsidered, as should the use of intraoperative cholangiography in CR+ patients with a palpable common bile duct stone or cholangitis. Intraoperative cholangiography in the remainder of CR+ patients proved beneficial and should be continued.

Adolescent↗
PubMed1991

Professional careers of 258 graduates of a 'fifth pathway' program.

Two hundred fifty-eight graduates (80%) of a fifth pathway program provided information about their professional careers. Fifty-nine percent practice primary care medicine, 25% are surgeons, and 16% are in support services such as psychiatry and radiology. Fifty-four percent are board certified, many of whom are doubly-board certified and some of whom hold prestigious academic positions. We conclude that properly educated fifth pathway graduates can become productive and respected members of the medical profession and contribute significantly to meeting the health-care needs of the patients and communities they serve.

Career Choice↗
PubMed1986

New York State mandatory seatbelt use law: patterns of seatbelt use before and after legislation.

A mandatory seatbelt use law, the first such law in the nation, became fully in force in New York State as of 1 January, 1985. We studied seatbelt use among drivers and front seat passengers involved in motor vehicle accidents for a 3-month period pre-legislation (Phase 1), and a 5-month period post-legislation (Phase 2), to determine if this type of compulsory law, providing civil fines of $50 for violators, changes seatbelt use behavior. The reported use rate among drivers rose from 21% pre-legislation to 47% post-legislation (p less than 0.01). The use rate among front seat passengers rose from 21% to 40% (not significantly different due to the small number of occupants recorded in this position). A highway survey (Phase 3) noted the use rate in New York City and surrounding counties to be 63%, a marked increase from the published pre-legislation value of 16%. We conclude that mandatory seatbelt use legislation is effective in significantly increasing seatbelt use and urge physicians to seek similar legislation in every state.

Accidents, Traffic↗
PubMed1985

Amylase isoenzymes in the acute abdomen: an adjunct in those patients with elevated total amylase.

The role of routine isoamylase determinations in differentiating acute pancreatitis from other causes of an acute abdomen with hyperamylasemia and/or hyperamylasuria was evaluated. Values were analyzed from a control group of 21 patients with acute pancreatitis (group I) and from 100 consecutive patients diagnosed in our emergency department as having an acute abdomen (group II). In group I, 100% of patients had hyperamylasemia, hyperamylasuria, and a P isoamylase fraction greater than 0.75 of the total amylase value. In group II, 50% of patients had hyperamylasemia and/or hyperamylasuria. Of these patients, 44% had a P isoamylase fraction less than 0.75 of the total amylase value, a finding apparently incompatible with a diagnosis of acute pancreatitis as identified by our control group. We conclude that routine isoamylase determinations in patients with an acute abdomen and hyperamylasemia and/or hyperamylasuria allows the differentiation from acute pancreatitis in 44% of cases.

Abdomen, Acute↗