Improving death certificate completion: a trial of two training interventions.

The death certificate is an important medical document that impacts mortality statistics and health care policy. Resident physician accuracy in completing death certificates is poor. We assessed the impact of two educational interventions on the quality of death certificate completion by resident physicians.

Modified Mid America Heart Institute Coronary Care Unit scoring system--a new comprehensive prognostic index for Coronary Care Unit patients.

Background: Prediction of long-term outcomes for patients presenting with cardiac events is important, but few predictive instruments are available. We previously developed an innovative scoring system, the Mid America Heart Institute (MAHI) Coronary Care Unit (CCU) scoring system, for quantifying outcomes of patients admitted to the CCU, using clinical events rather than solely physiologic and laboratory variables. The objective of our study was to validate a refined version of this system (MAHI-2) and to explore its prognostic value, we have postulated that patients with high MAHI scores would have higher mortality and morbidity in 1-year follow-up.

Death certificate completion: how well are physicians trained and are cardiovascular causes overstated?

Purpose: To determine the ability of residents in completing death certificates correctly.

Methods: A total of 4800 residents were asked to complete a survey and cause-of-death statement using a sample case of in-hospital death due to urosepsis, of whom 590 residents (12%) responded. A scoring scale designed based on instructions from the National Association of Medical Examiners and the American College of Pathologists was used to measure responses quantitatively.

Improving in-hospital mortality in the setting of an increasing risk profile among patients undergoing catheter-based reperfusion for an acute myocardial infarction without cardiogenic shock.

Unlabelled: Prompt myocardial reperfusion is the therapeutic goal for patients presenting with acute myocardial infarction (AMI). However, there remains a paucity of clinical data from single centers solely dedicated to a catheter-based reperfusion strategy. Therefore, we sought to identify significant predictors of in-hospital mortality, to determine the changing profile of patient demographics and to identify the mortality trend over time.

Complementary roles of color-flow duplex imaging and intravascular ultrasound in the diagnosis of renal artery fibromuscular dysplasia: should renal arteriography serve as the "gold standard"?

Objectives: The purpose of this study was to compare color-flow duplex imaging (CFDI), intravascular ultrasound (IVUS), and renal arteriography in diagnosing renal artery (RA) fibromuscular dysplasia (FMD) and correlating with the hemodynamic response to balloon angioplasty (BA) in patients with drug-resistant hypertension.

Background: Renal arteriography is generally regarded as the gold standard for diagnosing RA FMD. The observation that CFDI and IVUS depicted endoluminal abnormalities suggestive of RA FMD in some patients with normal renal arteriograms prompted comparison of these modalities in a consecutive series of patients.

Differential benefits and outcomes of tirofiban vs abciximab for acute coronary syndromes in current clinical practice.

Little comparative data exist for glycoprotein IIb/IIIa inhibitors in acute coronary syndromes (ACS). Two hundred twenty-eight patients were studied: 114 received tirofiban (TI) and 114 received abciximab (AB) for either unstable angina (UA) or myocardial infarction (MI). All patients received aspirin, heparin, and ticlopidine or clopidogrel.