Biomedical subjects

R L Lewis

Publications and source records attributed to R L Lewis.

11 recordsLinked to original sources

PubMed1995

Emergency department quality assurance/improvement practices for the pediatric patient.

STUDY OBJECTIVE: To describe emergency department quality assurance (QA)/improvement (QI) practices for pediatric patients. DESIGN: Mail survey of a cohort of emergency physicians. PARTICIPANTS: Pediatric Section members of the American College of Emergency Physicians and a computer-generated random sample of general ACEP members. RESULTS: Pediatric Section and general ACEP physicians were mailed a 13-question QA survey. Of the 500 surveys distributed, 207 (41.4%) were returned. Three emergency care settings for pediatric patients seen in the ED were identified: (1) children's hospital ED (14%), (2) general ED with a separate area designated for the evaluation of pediatric patients (12%), and (3) general ED where pediatric and adult patients are evaluated in the same area (74%). Separate QA indicators were used to monitor care of the pediatric patients seen in the ED by 61% of the respondents; 39% used "adult" indicators only. High pediatric census was associated with pediatric representation on the ED QA/QI Committee, the use of separate pediatric indicators to monitor care of pediatric patients in the ED, the separation of pediatric and adult patient care areas and satisfaction with the respondent's ED QA/QI plan. CONCLUSION: The bulk of pediatric emergency patients are cared for in a general ED. Most ACEP members surveyed reported the use of separate QA indicators to monitor the care of pediatric patients seen in the ED. This survey provides the first description of QA/QI practices for pediatric patients by EDs nationwide.

Child↗

PubMed1991

Electroanalytical characteristics of the cardiotonics, enoximone and piroximone.

Enoximone and piroximone are cardiotonic agents for use in patients with congestive heart failure. Electroanalytical studies revealed that the dihydroimidazolone functionality was oxidizable and that this property can be analytically useful. The compounds undergo a two-electron, irreversible oxidation in neutral to acidic media, leading to two major products. Results in basic media show up to three electrons transferred per molecule and much higher oxidation potentials at the fresh carbon paste electrode than at identical electrodes preconditioned in supporting electrolyte at +1.2 V. Use of amperometric detection with HPLC provides excellent measurement sensitivity (less than 1 ng) and reproducibility. Carbon paste and glassy carbon electrodes surfaces are not obviously affected by the electrochemical reactants or products. Piroximone, in addition, contains a 4-pyridoyl function which is irreversibly reducible at a mercury electrode, with excellent response linearity, and measurement sensitivity to at least 10(-7) M by differential pulse polarography.

Chromatography, High Pressure Liquid↗

PubMed1987

Exercise radionuclide assessment of left ventricular function before and after coronary bypass surgery.

The effects of elective saphenous vein coronary artery bypass surgery on left ventricular ejection fraction were assessed by using exercise first-pass radionuclide angiography in 66 consecutive patients. All patients with left main coronary artery or concomitant valvular disease were eliminated from the study. Before surgery, 7 patients had normal postexercise left ventricular function (Group 1), 33 had normal resting left ventricular function with an abnormal response to exercise (Group 2), and 26 had an abnormal resting left ventricular ejection fraction with an abnormal response to exercise (Group 3). Following surgery, patients in all three groups had no change in mean resting left ventricular ejection fraction; however, patients in Groups 2 and 3 had significant improvement in mean postexercise left ventricular ejection fraction (p less than 0.0001 and p less than 0.0054 respectively), whereas patients in Group 1 did not. Previous studies reported improvement in postexercise ejection fraction in patients with reduced resting left ventricular function and with an ischemic response to exercise (Group 3). But this is the first study to confirm improvement in postexercise function in patients with normal resting function and an ischemic response to exercise (Group 2).

Adult↗

PubMed1986