Detection of Common Arrhythmias by the Watch-PAT: Expression of Electrical Arrhythmias by Pulse Recording.

Background: The WatchPAT (WP) device was shown to be accurate for the diagnosis of sleep apnea and is widely used worldwide as an ambulatory diagnostic tool. While it records peripheral arterial tone (PAT) and not electrocardiogram (ECG), the ability of it to detect arrhythmias is unknown and was not studied previously. Common arrhythmias such as atrial fibrillation (AF) or premature beats may be uniquely presented while recording PAT/pulse wave.

Recent nonsteroidal anti-inflammatory drug use increases the risk of early recurrence of bleeding in patients presenting with bleeding ulcer.

Background: Nonsteroidal anti-inflammatory drug (NSAID) use is a well-known risk factor for ulcer formation and ulcer complications. The purpose of this study was to determine whether recent NSAID use increases the risk of early recurrence of bleeding in patients who present with bleeding ulcer.

Methods: Clinical and endoscopic data were collected prospectively.

The effects of the Northridge earthquake on the pattern of emergency department care.

This study's objective was to describe the types of injuries that should be anticipated after a major earthquake. Data for the 6 days prior to the earthquake, the 6 days after the earthquake, and for the day of the earthquake the previous year were obtained from the Emergency Department of Northridge Hospital, Northridge, CA. Demographic data, including age and sex, as well as the reason for the visit, were obtained from patient logs.

NSAIDs increase risk of gastrointestinal bleeding in primary care patients with dyspepsia.

Background: A 1-year prospective study of 545 patients with dyspepsia examined the natural history of dyspepsia in a primary care population. Predictors of gastrointestinal bleeding and other related utilization-of-service indicators were identified.

Methods: Subjects were adult primary care patients seen at a southern California county medical center.

Dyspepsia in primary care: perceived causes, reasons for improvement, and satisfaction with care.

Background: While dyspepsia is a common problem in primary care populations, very little is known about patient perceptions of medical care for this disease. The present study of patients with dyspepsia treated by primary care physicians looks at causes, procedures, and reasons for improvement from the patient's viewpoint and relates these factors to patient satisfaction with family physicians' medical care.

Methods: Medical chart and billing data were collected for 545 adult patients who visited five family health centers for digestive complaints during a 6-month period in 1993.

Meta-analysis of risk factors for peptic ulcer. Nonsteroidal antiinflammatory drugs, Helicobacter pylori, and smoking.

Attributable risk models describe the role of three risk factors for peptic ulcer and related serious upper gastrointestinal (GI) events. The factors-nonsteroidal antiinflammatory drugs (NSAIDs), Helicobacter pylori, and cigarette smoking-have been identified as major risk factors for peptic ulcer in numerous clinical and epidemiologic studies. Overall risk ratios for each risk factor were based on meta-analyses of English-language studies of risk for peptic ulcer-related GI events.

Transvascular albumin transport and protein replenishment after haemorrhage in the chronically catheterized pregnant rabbit.

Pregnancy is characterized by increases in both blood and interstitial volumes, but the mechanisms are unknown. To test the hypotheses that blood volume (BV) recovery after haemorrhage in pregnant (P) is faster than in nonpregnant (NP) rabbits, and that this can be explained by a higher capillary filtration, a 20% BV haemorrhage was produced in a group of 7 P and 7 NP rabbits. We determined the BV recovery (measured by 99Tc), the total plasma protein mass and the haematocrit at 10, 20, 30, 60 and 1440 min after haemorrhage.

Retrospective comparison of photorefractive keratectomy and radial keratotomy.

Background: The efficacy and predictability of photorefractive keratectomy and radial keratotomy become increasingly relevant. This retrospective study compares one surgeon's experience with photorefractive keratectomy and radial keratotomy over a 3-year period from 1990 to 1993.

Methods: Photorefractive keratectomy was performed on 103 eyes of 76 patients that met the inclusion criteria for the phase IIb, phase III, and phototherapeutic keratectomy studies as delineated by the United States Food and Drug Administration.

Laparoscopically guided peritoneal insertion in ventriculoperitoneal shunts.

A technique of laparoscopically guided insertion of the peritoneal end of ventriculoperitoneal shunts is described. Eleven consecutive cases were done in this manner. There were no failures in inserting the peritoneal end of the ventriculoperitoneal shunt catheter.

Endothelin-1 potentiates the in vitro contractile response of pregnant human myometrium to oxytocin.

Objective: This study was designed to test the hypothesis that endothelin-1 pretreatment of human myometrium at subcontractile doses in vitro will enhance the contractile response to oxytocin.

Study Design: In vitro contractile oxytocin dose-response curves were generated by use of myometrial strips collected from nonpregnant women (n = 7), pregnant patients at elective cesarean section (n = 7), and patients in active labor (n = 7) in the presence or absence of 10(-9) mol/L endothelin-1. Contractile responses were analyzed by on-line computer, and data were normalized to the maximum response to potassium.

Placental passage of the oxytocin antagonist atosiban.

Objective: We wanted to determine the degree of placental transfer of atosiban (Antocin), an oxytocin antagonist, in pregnant women at term. We also assessed the effects of the infusion on umbilical cord blood gases at birth and the maternal hematocrit drop after cesarean section.

Study Design: Eight women undergoing elective cesarean section at term were studied.

Peptic ulcer disease mortality. Comparison of native Japanese, Japanese Americans, and Caucasian Americans.

Peptic ulcer disease mortality patterns of California Japanese are compared with those of their home and host countries for even years from 1960 to 1988, as well as 1989. Data presented are consistent with the hypothesis that Helicobacter pylori is a necessary but not sufficient causal factor in peptide ulcer disease, and that other co-factors including cigarette smoking and salt intake may be important. Deaths due to peptic ulcer numbered 106 among California Japanese, 12,793 for California Caucasians, 107,461 in Japan, and 117,737 for United States Caucasians during the study period.

Is uterine blood flow controlled locally or systemically in the pregnant rabbit?

Objective: We tested the hypothesis that uterine blood flow is regulated by systemic circulating factors. The alternative hypothesis is that uterine blood flow is regulated by local factors.

Study Design: Adult female New Zealand White rabbits were subjected to a unilateral tubal ligation and thereafter allowed to become pregnant (n = 9).

Physiology of uterine activity in pregnancy.

During the past few years enormous progress has been made in the understanding of the molecular mechanisms involved in parturition; however, the answer to the fundamental question of how labor is initiated remains elusive. This is a very important question because alterations in the timing of birth (preterm and post-term deliveries) are associated with much of perinatal morbidity and mortality. Currently available treatments for preterm labor are not clearly effective.

Seroprevalence of human immunodeficiency virus among family practice outpatients.

Background: Because the human immunodeficiency virus (HIV) is extremely heterogeneous in its impact on various subpopulations, it is important to carry out HIV seroprevalence studies in different subpopulations using standardized techniques. The present study is the first to report seroprevalence rates of HIV in family medicine outpatient populations.

Methods: To estimate the prevalence and demographic distribution of HIV, 3874 sera samples were collected anonymously at six family medicine clinics in San Bernardino County during a 1-year period.

Patient and provider satisfaction with medical care.

Background: This study compares patient and provider satisfaction with medical care and waiting time in a large family medicine residency program. Few published studies have dealt with both patient and provider perceptions.

Methods: Telephone interviews were conducted with 156 adult, English-speaking patients who were randomly selected from daily appointment schedules.

Crohn's disease among ethnic groups in a large health maintenance organization.

The epidemiology of Crohn's disease (CD) was investigated among ethnic groups in a 2-million-member health maintenance organization. Between 1982 and 1988 there were 909 hospitalizations for CD. Annual hospitalizations per 100,000 were much lower for Hispanics (0.

A prospective study of risk for peptic ulcer disease in Seventh-Day Adventists.

Cross-sectional and prospective data were collected and analyzed to identify risk factors for the development of peptic ulcer disease in a population of 34,198 white, non-Hispanic Seventh-Day Adventists. On a life-style questionnaire administered in 1976, 3853 subjects reported ever having had a physician-diagnosed peptic ulcer for a lifetime prevalence of 13.5% for men and 11.

One gram of aspirin per day does not reduce risk of hospitalization for gallstone disease.

Data from 4524 patients in a randomized, controlled trial of aspirin were analyzed to determine if aspirin reduced the risk for hospitalization for gallstone disease. Aspirin at a dose of 1000 mg/day did not reduce the risk of hospitalization for gallstones. Hospitalization rates for gallstone disease were consistent with national rates, and the data confirmed previous associations of gallstone disease with age, elevated serum triglycerides, obesity, and female gender.

Spontaneous resolution of subdural hematomas.

From a series of 35 cases of subdural hematomas in a 12 months span, 6 cases of subdural hematomas which spontaneously resolved were found. The sizes of these hematomas ranged from the relatively small to the huge. All of these cases displayed little if any neurological deficit when seen by us.

AIDS in California family medicine. Changing experiences, knowledge, and geographic distribution.

Information regarding practice patterns specific to acquired immunodeficiency syndrome (AIDS) was obtained in 1988 from 1774 family physicians in California using a mail survey. Data were analyzed across the following county groupings: Los Angeles County, other counties in standard metropolitan statistical areas, and counties outside standard metropolitan statistical areas. Comparisons were made with the data from a telephone survey conducted in 1986.

Characteristics of group A streptococcal bacteremia in patients at the San Bernardino County Medical Center.

On the basis of a 12-year study of 58 patients at our medical center who had group A streptococcal bacteremia, we found that this disease is not uncommon when compared with other varieties of bacteremia. It occurs with about one-half of the frequency of bacteremias due to Klebsiella species and one-eighth of that of bacteremias due to Staphylococcus aureus. The infection is infrequently nosocomial (3.