Possible transmission of hepatitis A in a school setting.
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British Columbia↗
Biomedical subjects
S Kassam
Publications and source records attributed to S Kassam.
Comparing angiographic coronary revascularization strategies: a 'natural' experiment.
OBJECTIVE: To study the impact of intracoronary stents on clinical restenosis in the 'real world'. DESIGN: Retrospective comparison of the rates of clinical restenosis between two cohorts exposed to different strategies for percutaneous transcatheter intervention. The endpoint was the first of death, myocardial infarction, coronary artery bypass grafting, repeat percutaneous transluminal coronary angioplasty (PTCA) or repeat coronary angiography within nine months. SETTING: Tertiary care cardiac referral centre serving a large, metropolitan population. PATIENTS: Patients undergoing angiographic revascularization from January 1 to February 28, 1996 (the 'restricted' group [R], n=147) were compared with a before and after cohort (the 'usual' group [U], n=232, divided into those who underwent revascularization between November 1 and November 30, 1995, and those who underwent revascularization between April 1 and May 31, 1996). INTERVENTIONS: The R group was revascularized during a period of economic constraint, which imposed a shortage on stent availability. The U cohort underwent revascularization before and after the shortage (an 'unrestricted' environment for stent usage). MAIN RESULTS: There was no difference in clinical restenosis rates between the R (34.7%) and U (37.9%) groups (P=0.524, OR R/U=0.915, 95% CI 0.694 to 1.206). Also, the rate of clinical restenosis was the same among patients who underwent PTCA without stent insertion (34.8%) and those who received a stent (39.4%) (P=0.368, OR=1.13, 95% CI 0.87 to 1.44). CONCLUSIONS: At the authors' institution, a restricted stenting policy did not result in a higher clinical restenosis rate than that of usual practice.
Angioplasty, Balloon, Coronary↗
Predictors of same-admission cardiac catheterization in patients with acute ischemic syndromes.
BACKGROUND: Various strategies exist for the use of cardiac catheterization in unstable angina or non-Q wave myocardial infarction. At the authors' institution, the overall volume of cardiac catheterization has increased in recent years. OBJECTIVE: To investigate whether this increased volume of cardiac catheterization was due to adoption of a more invasive approach to the management of patients with acute ischemic syndromes. DESIGN: A retrospective cohort study was conducted using detailed chart review of coronary care unit admissions during 1990/91 and 1993/94. SETTING: A university-affiliated tertiary care referral centre with facilities for cardiac catheterization. PATIENTS: One hundred patients randomly selected from among those with unstable angina, non-Q wave myocardial infarction or chest pain not yet diagnosed in each of the study years. Detailed follow-up was complete for all patients. OUTCOME MEASURE: The use of cardiac catheterization during the index admission was documented. MAIN RESULTS: There was a trend towards more frequent use of same admission cardiac catheterization in the later period (21% [CI 14% to 31%] versus 12% [CI 7% to 20%], P = 0.09). However, after controlling for baseline characteristics and in-hospital events, the year of admission did not independently predict the use of catheterization (P = 0.60). By multivariate logistic regression, recurrence of chest pain and evidence of myocardial necrosis were most closely associated with same-admission cardiac catheterization. CONCLUSIONS: Although clinical factors partially explain the increased use of catheterization over time, there may have also been shift towards a more aggressive practice style at the authors' institution. Further study is needed to address this possibility.
Acute Disease↗
[Rickets. Classification and treatment].
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Humans↗
Shigella and shigellaemia.
Two cases of bacteraemia with Shigella flexneri 2a in children are described. They illustrate the wide variety of clinical manifestations of shigellosis, ranging from benign gastroenteritis to septicaemia associated with severe extra-intestinal manifestations.
Ampicillin↗
[Acute myeloblastosis in von Jaksch-Luzet syndrome].
A 7 month-old infant of Italian origin, who was given a vitamin-D deficient diet developed a Von Jaksch-Luzet syndrome with more than 20% myeloblasts in the bone marrow. Plasma levels of vitamin D metabolites wer low and parathormone levels were high. A low dose of vitamin D3 (2,000 IU cholecalciferol/day) resulted in the recovery of a normal phosphocalcic balance and in the disappearance of myeloblastosis.
Calcifediol↗