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Biomedical subjects

R Hobbs

Publications and source records attributed to R Hobbs.

46 records · Page 3Linked to original sources
PubMed1989

Use of digital subtraction fluorography in screening for coronary artery disease in patients with chronic renal failure.

The diagnosis of coronary artery disease remains a major problem in patients with end-stage renal disease. Screening with conventional noninvasive techniques is limited by the poor exercise capacity of these patients. This study evaluated the accuracy of digital subtraction fluorography in detecting coronary calcification as a noninvasive, nonexercise screening test for coronary artery disease. Eighty-six patients under evaluation for renal transplantation and considered at increased risk of coronary artery disease were studied by coronary arteriography and digital subtraction fluorography for coronary calcification. Significant coronary disease (greater than or equal to 50% obstruction in at least one vessel) was present in 36 (42%) patients. The detection of coronary calcification by digital subtraction fluorography had a sensitivity of 78% and a specificity of 66%. The probability of disease being present in the absence of coronary calcification in this group was 18%. The detection of coronary calcification by digital subtraction fluorography appears to be a satisfactory and inexpensive screening test in this setting.

Calcinosis↗
PubMed1984

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Education, Medical, Continuing↗
PubMedDate not supplied

Use of a clinical care map for the management of congestive heart failure in a community hospital.

BACKGROUND. Managed care rewards those individuals and institutions capable of achieving superior patient outcomes while making wise use of limited resources. However, studies of patient outcomes under these circumstances are lacking. We sought to investigate whether decreasing length of stay and limiting resource utilization had a negative effect on objective measurements of patient outcome for patients with congestive heart failure. METHODS. Guided by studies of evidence-based medicine, a multidisciplinary team developed and implemented a clinical care multidisciplinary action plan for the inpatient management of congestive heart failure. This provided practitioners with a target length of hospital stay, projections for daily improvements based on intervention, guidelines for diagnostic studies and medical therapy, early identification of patients with special discharge needs, and intensive patient education. RESULTS. Shorter lengths of stay for patients with congestive heart failure were achieved without negatively impacting on mortality or readmission rates. The study found a trend in favor of greater utilization of appropriate medical therapy despite shorter hospitalization. CONCLUSION. The use of a clinical care map for management of complex medical illnesses can be associated with shorter hospital stay without sacrificing patient outcomes. (c)2001 by CHF, Inc.

Journal Article↗