PubMed Health⌕ Search

Biomedical subjects

R V Erickson

Publications and source records attributed to R V Erickson.

13 recordsLinked to original sources
PubMed2001

Risk factors for post-ERCP pancreatitis: a prospective, multicenter study.

BACKGROUND: Post-ERCP pancreatitis is poorly understood. The goal of this study was to comprehensively evaluate potential procedure- and patient-related risk factors for post-ERCP pancreatitis over a wide spectrum of centers. METHODS: Consecutive ERCP procedures were prospectively studied at 11 centers (6 private, 5 university). Complications were assessed at 30 days by using established consensus criteria. RESULTS: Pancreatitis occurred after 131 (6.7%) of 1963 consecutive ERCP procedures (mild 70, moderate 55, severe 6). By univariate analysis, 23 of 32 investigated variables were significant. Multivariate risk factors with adjusted odds ratios (OR) were prior ERCP-induced pancreatitis (OR 5.4), suspected sphincter of Oddi dysfunction (OR 2.6), female gender (OR 2.5), normal serum bilirubin (OR 1.9), absence of chronic pancreatitis (OR 1.9), biliary sphincter balloon dilation (OR 4.5), difficult cannulation (OR 3.4), pancreatic sphincterotomy (OR 3.1), and 1 or more injections of contrast into the pancreatic duct (OR 2.7). Small bile duct diameter, sphincter of Oddi manometry, biliary sphincterotomy, and lower ERCP case volume were not multivariate risk factors for pancreatitis, although endoscopists performing on average more than 2 ERCPs per week had significantly greater success at bile duct cannulation (96.5% versus 91.5%, p = 0.0001). Combinations of patient characteristics including female gender, normal serum bilirubin, recurrent abdominal pain, and previous post-ERCP pancreatitis placed patients at increasingly higher risk of pancreatitis, regardless of whether ERCP was diagnostic, manometric, or therapeutic. CONCLUSIONS: Patient-related factors are as important as procedure-related factors in determining risk for post-ERCP pancreatitis. These data emphasize the importance of careful patient selection as well as choice of technique in the avoidance of post-ERCP pancreatitis.

Cholangiopancreatography, Endoscopic Retrograde↗
PubMed1998

Endoscopic surveillance of Barrett's esophagus: a cost-effectiveness comparison with mammographic surveillance for breast cancer.

OBJECTIVE: Endoscopic surveillance of Barrett's esophagus is commonly practiced to detect malignancy in an early and curable stage. However, the cost-effectiveness of this practice has been questioned. To clarify this issue, we undertook a cost analysis of endoscopic surveillance to detect adenocarcinoma in Barrett's esophagus compared with mammography used to detect occult carcinoma of the breast, a widely accepted cancer surveillance technique. METHODS: The rate of esophageal adenocarcinoma detected by endoscopic surveillance was calculated for Duluth Clinic patients with Barrett's esophagus seen from 1980 to 1995 and compared with published rates. The rate of occult breast cancer detection was calculated for all women undergoing surveillance mammography at the Duluth Clinic for the year 1994 and compared with published rates. Costs for screening studies and therapy for cancer treatment for both cancers were calculated based on clinical results and assumptions regarding outcomes derived from published reports, and the costs were compared. RESULTS: Endoscopic surveillance of 149 patients with benign Barrett's esophagus was performed for a total of 510 patient-yr, during which time seven patients developed adenocarcinoma, an incidence of one case per 73 patient-yr of follow-up. Occult breast cancer was detected in 50 of 12,537 mammograms, a detection rate of 0.4%. The incidences in both cases were comparable to published figures. The costs of detecting a case of adenocarcinoma in Barrett's esophagus and occult breast cancer were $37,928 and $54,513, respectively, and those for treatment resulting in cure were $83,340 and $83,292. Cost per life-yr saved was $4,151 for adenocarcinoma in Barrett's esophagus and $57,926 for breast cancer. CONCLUSION: Endoscopic surveillance of patients with Barrett's esophagus compares favorably with the common practice of surveillance mammography to detect early breast cancer, and should therefore be considered to be as cost-effective as surveillance mammography.

Adenocarcinoma↗
PubMed1997

Repair of aortoesophageal fistula after aortic grafting.

This report describes repair of an aortoesophageal fistula caused by a previously placed thoracic aortic graft. The diagnosis was made by esophagoscopy. The repair consisted of femoral-to-femoral cardiopulmonary bypass, excision of the old graft, placement of a new graft, esophagectomy, cervical esophagostomy, gastrostomy, and later reconstruction by cervical esophagogastrostomy.

Aorta↗
PubMed1993

Tuberculin reactivity is low among residents of a Connecticut nursing home.

Of 131 residents of a suburban New England intermediate and skilled nursing facility, 126 agreed to be evaluated by two-stage administration of purified protein derivative (5TU) for tuberculin reactivity. Only eight patients (6.4%) had a positive reaction, considerably fewer than reported by most previous studies. There were no statistically significant differences between reactors and nonreactors based in age, gender, or length of stay in the facility. There was a tendency toward an association of presence of risk factors and a positive response to tuberculin skin testing, but this did not achieve statistical significance (P = 0.063).

Adolescent↗
PubMed1985

Cultural barriers to effective medical care among Indochinese patients.

Since 1975, over 600,000 Indochinese refugees have resettled in the United States. This patient population has significant personal health problems in need of medical treatment. However, Indochinese refugees frequently underutilize existing health care services. This, in part, results from major cultural barriers between patient and provider. A review is provided of the history of the recent Indochinese immigration and the cultural traits, religious beliefs, and health care practices of this refugee population. This information is provided in the hope that health care providers will learn to understand the Indochinese refugee as a patient and reduce those cultural barriers that appear to limit their access to medical care in this country.

Adult↗
PubMed1982

Guidelines for providing medical care to Southeast Asian refugees.

Almost 500,000 Southeast Asian refugees have arrived in the United States since 1975. While these refugees have not presented substantial public health problems, they have important personal health problems frequently requiring medical attention. Medical care providers in this country need to be aware of disease patterns and prevalence among these refugees. As well, they need to be aware of the cultural and religious backgrounds and previous medical practices of this refugee population, particularly as these practice influence the refugees' ability to obtain and maintain medical services provided in this country. Historical, cultural, religious, ethical, and medical information is provided to help US health care facilities develop culturally appropriate medical care services for Southeast Asian refugees.

Acculturation↗
PubMed1980

Health problems among Indochinese refugees.

The results of medical evaluations of 194 recent indochinese refugees are reported. In addition to confirming findings of other studies of these refugees, we found a significant prevalence of abnormalities, i.e., hematological (37 per cent), dermatological (26 per cent), psychiatric (10 per cent of adults), and thyroid (5 per cent). Guidelines and recommendations of physicians providing medical care for indochinese refugees are presented.

Adolescent↗