PubMed Health⌕ Search

Biomedical subjects

S K Broste

Publications and source records attributed to S K Broste.

41 records · Page 3Linked to original sources
PubMed1986

A modified actuarial life-table approach to the analysis of implantable device performance.

The actuarial life-table method is often used by pacemaker manufacturers and the pacing research community to describe pacemaker and lead performance. Most life-table methods allow for differing lengths of follow-up but assume that all devices were followed from implant. Occasionally, however, devices come under follow-up observation sometime after implant. This presentation describes an extension of the actuarial method to accommodate these kinds of data. The specific example to be considered involves follow-up data collected by CardioCare, a commercial cardiac monitoring service, on the performance of Medtronic polyurethane leads. Patients subscribe to this service, generally at some time after actual device implant. Results showed that of 12,112 patients with Models 4002, 6971, and 6972 leads who were followed by CardioCare, only 85 were followed from implant. If one were to exclude patients not followed since implant, more than 99% of the data would be lost. Using the modified approach with allowance for postimplant, entry resulted in an estimated three-year cumulative survival probability for these leads of 95.7%. Treating all patients as if they were followed since implant, the probability would be 96.9%, an optimistic and biased estimate.

Actuarial Analysis↗
PubMedDate not supplied

Treatment of iron deficiency anemia and associated protein-losing enteropathy in children.

PURPOSE: The aims of this study were to evaluate the response of oral iron treatment in children with iron deficiency anemia (IDA) fed whole cow's milk (WCM) or soy formula; to compare the incidence of fecal blood loss in infants fed WCM and soy formula; and to evaluate the incidence and relation of protein-losing enteropathy (PLE) and IDA by testing serum albumin, fecal blood loss, and fecal alpha1-antitrypsin (alpha1AT). METHODS: Twenty-four children with nutritional IDA were randomly assigned to receive either 16 oz WCM or soy formula daily. Both groups were treated with daily therapeutic oral iron during 12 weeks. Stool specimens for hemoglobin losses were collected at weeks 0, 3, 6, and 12. Levels of serum albumin and fecal alpha1AT were tested at diagnosis and when IDA was corrected. RESULTS: Anemia was corrected in 21 of the 24 children by week 6 or 12. Median fecal hemoglobin losses were not increased in either group at diagnosis or during treatment. Seven of 24 children had PLE at diagnosis with elevated fecal alpha1AT levels of 72 to 381 mg/dL that returned to normal after correction of IDA. Their initial fecal alpha1AT levels averaged 170 mg/ dL at diagnosis and 21 mg/dL after the IDA was corrected. Excessive WCM intake of 30 oz/day or more was present in 63% of the infants. CONCLUSIONS: Treatment of nutritional IDA with oral iron was just as effective with a limited quantity of either WCM or soy formula. Fecal hemoglobin losses were uncommon and did not differ in children at diagnosis or during treatment of IDA. PLE associated with IDA resolves when the IDA is corrected, but differences between children fed WCM or soy formula could not be detected.

Anemia, Iron-Deficiency↗
PubMedDate not supplied

Epilepsy and traffic safety.

We previously reported that drivers with epilepsy have somewhat higher age-adjusted rates of traffic accidents and moving violations than do drivers without epilepsy. We attempted to identify medical and other factors contributing to this increase. Medical records of 241 drivers with a history of seizures, representing essentially all such persons from a contiguous seven ZIP postal code area served by the Marshfield Clinic were studied. This zip code refers to a defined geographic area around Marshfield where virtually the entire population receives its care at the Marshfield Clinic and for which we have accurate records. Information abstracted from medical charts was used to identify potential risk factors for traffic accidents and violations among these drivers. Careless driving violations, alcohol or drug violations, and accidents (especially injury accidents) occurred at higher rates and speeding violations occurred at lower rates for drivers with epilepsy. Young age, unmarried state, history of multiple seizures, and lack of antiepileptic drug (AED) treatment appear to be risk factors for accidents among drivers who had a history of seizures. Male sex, psychiatric disorders, alcohol abuse, and generalized seizures or complex partial seizures (CPS) were also suggestively associated with higher risk. For moving violations, young age, male sex, unmarried state, symptomatic etiology, and history of alcohol abuse contributed to increased risk. We conclude that drivers with epilepsy appear to have identifiable risk factors for traffic mishaps, especially accidents.

Accidents, Traffic↗