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Biomedical subjects

G F Wright

Publications and source records attributed to G F Wright.

11 recordsLinked to original sources
PubMed1995

Learning from adversity: diary of a medical manager.

This article is one physician's account of his experiences in managing a large multispecialty group practice. While he was able to accomplish much in his tenure during the latter half of the 1980s, it was, on balance, a negative experience. He describes both the high and the low points of the period and assesses how both contributed to his eventual downfall. While personal, the account has important implications for others involved in the rapidly changing, personally rewarding, and eminently challenging health car system in which physician executives work.

Cost-Benefit Analysis↗
PubMed1986

Escherichia coli O157:H7 diarrhea in a nursing home: clinical, epidemiological, and pathological findings.

In September 1984, an outbreak of Escherichia coli O157:H7 infection occurred in a nursing home. It was the first recognized outbreak of this organism in the United States since 1982, when two outbreaks led to its recognition as a pathogen. Thirty-four of 101 residents developed a diarrheal illness; 14 were hospitalized with a severe illness characterized by crampy abdominal pain, marked abdominal distention, and grossly bloody diarrhea, and four died. The spectrum of illness associated with the infection was broad and included the following: asymptomatic infection, nonbloody diarrhea, hemorrhagic colitis, hemolytic uremic syndrome, and death. Clinical, radiographic, and postmortem pathological findings suggested involvement of the cecum and right colon. No evidence of response to antimicrobial agents could be documented, and antidiarrheal agents may have aggravated the disease. This investigation implicated hamburger as the vehicle transmission. Seventeen of 19 residents with hemorrhagic colitis, but only 28 of 67 healthy residents, had eaten hamburger on 13 September (P less than .001, Fisher's two-tailed exact test; relative risk [RR] = 7.7). Infection with E. coli O157:H7 can cause a wide range of manifestations. In the elderly these can be particularly severe and may resemble ischemic colitis.

Adult↗
PubMed1984

The risk of vascular surgery in a metropolitan community. With observations on surgeon experience and hospital size.

From 1978 through 1981 complete perioperative information concerning a total of 10,189 peripheral vascular procedures performed in northeastern Ohio was recorded in the computer registry of The Cleveland Vascular Society. This report is an analysis of mortality and morbidity rates for all 5686 operations involving carotid endarterectomy (N = 2646), lower extremity revascularization (N = 1987), and abdominal aortic aneurysm resection (N = 1053). The operative mortality rate was 1.2% for carotid reconstruction, 2.8% for femoropopliteal or distal bypass, 3.5% for aortofemoral revascularization, and 11.9% for aortic aneurysm resection (elective operations 6.5%; emergency operations 32.9%). Postoperative strokes occurred after endarterectomy in 2.7% of patients having preoperative neurologic symptoms and in 2.0% of those with asymptomatic carotid stenosis. Lower extremity amputation was unavoidable in 1.5% of patients after aortofemoral reconstruction and in 6.0% after femoropopliteal or distal bypass. Statistical testing indicated that the operative mortality rate was not related to the respective size of the 27 hospitals involved in the survey. The relative annual experience of the 29 participating surgeons significantly influenced only the mortality rate of elective aneurysm resection and the amputation rate after femoropopliteal or distal revascularization. This study suggests that the results of major arterial reconstruction in metropolitan areas may be expected to be comparable to those of published series if the responsible surgeons are specifically trained and maintain an active interest in the field of vascular surgery.

Aorta, Abdominal↗