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Biomedical subjects

E McCarthy

Publications and source records attributed to E McCarthy.

At least 55 records · Page 3Linked to original sources
PubMed1989

Coronary heart disease and related procedures. National Hospital Discharge Survey data.

The National Hospital Discharge Survey provides cross-sectional and trend data for analysis of cardiovascular diseases that may require surgery or other procedures. Overall, there was a decline in the hospital discharge rate for all causes since 1983. However, the number of discharges with first-listed coronary artery-related diagnoses increased between 1984 and 1986. For men, the estimated number of these discharges increased from 1,161,000 to 1,323,000. For both sexes, there was a decrease for chronic ischemic heart disease; however, the number of discharges for unstable angina pectoris doubled over this period. It is uncertain whether this reflects an increase in disease or is the result of reimbursement policies affecting diagnosis. For both unstable and stable angina pectoris, there was a reversal of the male-female ratio at older ages, with larger numbers of older women than men discharged with these diagnoses. The discharge rates for all-listed acute myocardial infarction remained relatively constant over the past 7 years. However, the average length of stay decreased. Dysrhythmias and heart failure were the most frequent complications listed. The number of coronary artery bypass graft surgery discharges increased from 114,000 in 1979 to 228,000 in 1986. The increase in coronary angioplasty is noteworthy, rising from 2,000 to 133,000 in the same period. For both procedures, the most frequently associated diagnosis was chronic ischemic heart disease. Further monitoring of hospital discharge trends for coronary heart disease and related procedures is indicated.

Angiography↗
PubMed1989

Hospital use in France and the United States.

This report presents national statistics on hospital use from the U.S. National Hospital Discharge Survey conducted by the National Center for Health Statistics and the national survey of hospitalization conducted by CREDES, Centre de Recherche d'Etude et de Documentation en Economie de la Santé, previously the Medical Economics Division of CREDOC. The use statistics compared between the two countries include rates and percent distributions of discharges and days of care and average lengths of stay. These statistics are shown by sex, age, diagnostic category, and other hospital and patient characteristics. The similarities and differences between the two countries in population characteristics, causes of death, health care systems, and hospital systems are also described.

Adolescent↗
PubMed1988

National trends in lens extraction: 1965-1984.

This paper describes the impact of modern technology on extraction of lens procedures. National estimates are presented on inpatient hospital utilization based on data collected through the National Hospital Discharge Survey. Trend data are shown for numbers, rates and average lengths of stay for patients with the procedure for 1965-1984. The trend data demonstrate changes in the procedure brought about by the effect of brought about by the effect of the introduction of Medicare and the introduction of the intraocular lens implant. Data on insertion of intraocular lens prosthesis are also presented for 1979-1984.

Age Factors↗
PubMed1987

Hospital use patterns for children in the United States, 1983 and 1984.

The hospital discharge rate of children less than 15 years of age in the United States declined 12% from 1983 to 1984. This was the first time in the 20-year history of the National Hospital Discharge Survey that there was a statistically significant decrease in children's hospital discharge rates in a 1-year period. The change occurred during a period when prospective hospital payment systems were introduced and when prepaid group health plans and alternative systems of providing health care were expanding. The unprecedented decrease in children's hospital use was evaluated using data from the National Hospital Discharge Survey. This is a continuous survey in which data from a national sample of medical records of discharged patients are collected. Children's hospital use rates were reviewed by age, sex, region, and expected principal source of payment. Significant decreases in discharge rates were found for the age group 1 to 4 years and for all children with private insurance. The patterns and changes in hospital use by diagnostic category were also investigated. The major finding was a 19% decrease in children's discharge rate for diseases of the respiratory system. Mortality statistics and data from the National Health Interview Survey were evaluated for indications of changes in children's health status or use of physician services accompanying the decline in hospital use. Although there were fewer deaths due to respiratory diseases for children less than 5 years of age in 1984 than in 1983, most measures of health status were unchanged. The only significant change in physician use was a decrease in the percentage of acute conditions that were medically attended, also among children less than 5 years of age. It is important to continue monitoring children's hospital use patterns, as well as their health status and use of alternative health services, to further assess the impact of changes in the organization and financing of health services.

Adolescent↗
PubMed1984

Hospital use by children in the United States and Canada.

The hospital discharge rate of children under 15 years of age is lower in the United States than in many other countries. This comparison of children's hospital use in the United States and Canada explores possible reasons for the relatively low discharge rate of U.S. children. Discharge rates are compared by age, sex, diagnosis, and surgical procedure. Morbidity and mortality rates are examined for indications that U.S. children are in better health than Canadian children and thus are less likely to need hospitalization. Characteristics of the health services systems in the two countries are investigated for evidence that ambulatory care is substituted for inpatient care in the treatment of U.S. children or that U.S. children have greater problems obtaining access to hospital care than Canadian children.

Adolescent↗
PubMed1983

Efficacy, safety, and pharmacokinetics of a concentration-maintaining regimen of intravenous pirmenol.

A 3-stage, concentration-maintaining intravenous infusion regimen of pirmenol, a new antiarrhythmic agent, was tested for efficacy and safety in 8 subjects with chronic, stable premature ventricular beats. The regimen, which consisted of (1) a priming bolus of 50 mg over 2 minutes, followed by (2) a rapid loading infusion of 2.5 mg/min for 1 hour, and (3) a maintenance infusion of 0.25 mg/min, rapidly achieved and maintained stable plasma pirmenol levels from 0.94 to 2.75 micrograms/ml, during infusions lasting up to 48 hours. Therapeutic efficacy was evaluated during 4-hour infusions in 5 patients utilizing a randomized, double-blind, placebo-controlled study design. Pirmenol suppressed average premature ventricular beat frequency 93 +/- 6% compared with control values (p = 0.03). Pirmenol infusions were unassociated with toxicity. There were slight but significant increases in diastolic blood pressure, QRS duration, and corrected Q-T interval. No significant changes occurred in systolic blood pressure, heart rate, P-R interval, or laboratory variables. Pirmenol is a promising therapeutic agent that warrants further evaluation. The 3-stage infusion satisfactorily achieves and maintains therapeutic plasma pirmenol levels.

Adult↗
PubMed1982

Pharmacokinetics of verapamil: experience with a sustained intravenous infusion regimen.

Disappearance kinetic characteristics of verapamil were determined in 9 patients after a single intravenous dose. From the pharmacokinetic variables determined, we designed an intravenous regimen to maintain a plasma verapamil concentration of 150 ng/ml consisting of (1) a loading bolus (10 mg over 2 minutes), followed by (2) a rapid loading infusion (0.375 mg/min) for 30 minutes, and finally (3) a maintenance infusion (0.125 mg/min). We tested this regimen in 7 patients for 2 to 12 hours, and found it to be safe and to produce stable prolongation of the P-R interval. Verapamil concentration was highest immediately after the bolus administration and was prevented from falling below 67 ng/ml by the rapid infusion. Maintenance concentration remained between 77 and 156 ng/ml for all patients, and averaged 122 ng/ml. Transient and slight decreases in brachial blood pressure and sinus cycle length occurred coincident with the maximum verapamil concentration. Maximum P-R prolongation lagged behind peak plasma concentration but was sustained for the duration of the infusion. Prolongation of the P-R interval was not significantly different at the end of the infusion from that 90 minutes after the start of the regimen. No patient demonstrated significant side effects, arrhythmia, or clinically important hypotension. Although the specified regimen produced a final concentration averaging 125 ng/ml, it is predicted that infusion regimens producing other plasma concentrations can be similarly devised by changing the bolus, rapid loading infusion, and maintenance infusion doses in proportion to the desired final plasma concentration.

Adult↗
PubMed1981

Inpatient utilization of short-stay hospitals by diagnosis United States, 1978.

Statistics are presented on the utilization of non-Federal short-stay hospitals based on data abstracted in the National Hospital Discharge Survey from a national sample of hospital records of discharged inpatients. The number of discharges, discharge rates, and average length of stay are shown for the classes and categories of first-listed diagnoses, by demographic characteristics of inpatients discharged and by geographic region and size of the hospitals. For these patient and hospital characteristics, this report also presents the number and percent distribution of all-listed diagnoses (up to five diagnoses per patient) reported for inpatients discharged.

Acute Disease↗