Determining appropriateness of coronary thrombolysis in the emergency department.

Study Objective: To estimate the appropriateness of decision-making by emergency physicians regarding coronary thrombolysis.

Methods: We conducted a retrospective chart review of patients admitted over a period of 13 months from a tertiary care center emergency department with a diagnosis of an acute ischemic coronary syndrome. Both thrombolysed and nonthrombolysed patients were eligible for inclusion.

The epidemiology of acute myocardial infarction and ischemic heart disease in Canada: data from 1976 to 1991.

Objective: To present national trends in mortality rates for myocardial infarction and cardiovascular disease.

Design: Observational study using mortality statistics and hospital separation data from Statistics Canada for the period 1976 to 1991.

Results: Despite ageing of the population, there has been a substantial decrease in the number of deaths attributed to ischemic heart disease, from 51,000 in 1976 to 44,000 in 1991, with most of the decrease due to fewer deaths from myocardial infarction.

The long term prognosis in patients following thrombolysis for acute myocardial infarction: a view from a community hospital.

Thrombolysis in patients with acute myocardial infarction has been established to improve hospital survival. Less information is available about the long term evolution of unselected patients seen in community hospitals. Consequently, consecutive patients treated with thrombolysis for acute myocardial infarction and surviving until hospital discharge (n = 129) were followed for an average of 22 months.

The Galway Study of Panic Disorder. III. Outcome at 5 to 6 years.

Background: The aim was to evaluate long-term outcome of DSM-III-R panic disorder at a mean of 5.3 years following a controlled trial of treatment that included antidepressants and behavioural counselling.

Method: Sixty-eight (86%) subjects were evaluated by lengthy research interview.

Placing trials in context using Bayesian analysis. GUSTO revisited by Reverend Bayes.

Standard statistical analyses of randomized clinical trials fail to provide a direct assessment of which treatment is superior or the probability of a clinically meaningful difference. A Bayesian analysis permits the calculation of the probability that a treatment is superior based on the observed data and prior beliefs. The subjectivity of prior beliefs in the Bayesian approach is not a liability, but rather explicitly allows different opinions to be formally expressed and evaluated.

Diagnosis and management of heart failure. Canadian Cardiovascular Society.

Many of the recommendations presented in this consensus report are summarized in Figure 2. All patients with known or suspected heart failure should undergo a detailed history and physical examination. Other causes for the symptoms and/or clinical signs indicative of heart failure should be excluded.

Long-term prognosis of patients presenting to the emergency room with decompensated congestive heart failure.

Objectives: This observational study was done to describe the long term prognosis of patients presenting to an emergency room with decompensated heart failure and to determine the factors that influence their survival.

Design: The routine clinical and laboratory characteristics of consecutive patients presenting to an emergency room with decompensated heart failure were documented and the patients followed for an average of 44 months (range 41 to 47).

Setting: One teaching hospital and one community-based hospital in Montreal, Quebec.

Personality disorder, symptoms and dexamethasone suppression in depression.

The presence of Personality Disorder (PD) in depressed patients admitted to the acute wards of a psychiatric hospital was assessed using Tyrer's Personality Assessment Schedule, and its relationship to depressive symptoms, improvement after 2 weeks, and the dexamethasone suppression test was examined. 75.4% of the sample met Tyrer's criteria for a PD diagnosis.

Secondary amines isolated from venom gland of dolichoderine antTechnomyrmex albipes.

A series of unsaturated secondary amines have been isolated from the dolichoderine antTechnomyrmex albipes (F. Smith). The major components of the mixture have been shown by spectroscopic procedures to be dinon-8-enylamine, andN-hept-6-enylnon-8-enamine, and these structural assignments have been confirmed by synthesis.

Informed decision making: the new paradigm.

Health care cannot survive in its present form. It is becoming unaffordable for a large share of the country's population. Its quality and effectiveness inexplicably vary between communities and across time.

The hospital course and short term prognosis of patients presenting to the emergency room with decompensated congestive heart failure.

Objectives: This observational study was done to describe the characteristics, hospital course and short term prognosis of patients presenting to an emergency room with decompensated heart failure and to determine the parameters influencing the length of their hospital stay.

Design: The routine clinical and laboratory characteristics of consecutive patients presenting to an emergency room with decompensated heart failure were documented and the patients followed for six months.

Setting: One teaching hospital and one community-based hospital in Montreal, Quebec.

WEDI (Workgroup for Electronic Data Interchange) co-chair predicts big savings from EDI.

Electronic data interchange has the potential to save billions of healthcare dollars--that's the gospel according to Joe Brophy. The Travelers Insurance Company president and co-chair of the Health and Human Services Workgroup on Electronic Data Interchange is taking this sermon to the people.

Epidemiology of congestive heart failure: Canadian data from 1970 to 1989.

Objective: To assess mortality rates from congestive heart failure in Canada from 1970 to 1989.

Design: Observational, retrospective design using national population and mortality data.

Main Results: There is a definite age gradient for deaths from congestive heart failure which, combined with a general ageing of the Canadian population, has lead to an increase in the absolute number of deaths.