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A community-wide study was conducted in 16 short-stay hospitals in metropolitan Worcester, Mass, to examine the incidence and case-fatality rates of deep vein thrombosis and pulmonary embolism in patients hospitalized between July 1, 1985, and December 31, 1986. The average annual incidence of deep vein thrombosis alone was 48 per 100,000, while the(More)
Amiodarone hydrochloride, an iodine-rich drug used in the treatment of tachyarrhythmias, is responsible for the development of thyrotoxicosis in approximately 10% of patients who reside in areas of moderate iodine deficiency. Treatment of amiodarone-induced thyrotoxicosis is difficult since the drug has a prolonged half-life, cardiac decompensation due to(More)
BACKGROUND A recent survey of American thyroidologists defining their management of a 43-year-old woman with hyperthyroid Graves' disease and a thyroid weighing 40 to 50 grams revealed that 69% recommended iodine 131 therapy, 30% prolonged antithyroid drug therapy, and only 1% operation. If the patient was younger or had a larger thyroid, 4% to 7% of the(More)
OBJECTIVE To determine the rate of use of prophylaxis for venous thromboembolism in high-risk hospital patients. DESIGN A retrospective medical record review. SETTING A community-wide study in 16 short-stay hospitals in central Massachusetts. PATIENTS A total of 2017 patients with multiple risk factors for venous thromboembolism. MEASUREMENTS AND(More)
Despite the recent advances in hepatobiliary imaging, the diagnosis of chronic acalculous gallbladder disease remains difficult. A retrospective study was undertaken to assess the value of a multiimaging approach in detecting chronic acalculous gallbladder disease and in predicting which patients would obtain symptomatic relief after cholecystectomy. Of 199(More)
OBJECTIVE To determine the effect of continuing medical education (CME) with and without a quality assurance component (CME+QA) on physician practices in the prevention of venous thromboembolism. METHODS A communitywide study was performed in 15 short-stay hospitals in central Massachusetts. The study population included 3158 patients in acute-care(More)
It has been suggested that intrathyroidal plasma cells are the major site of TSH receptor antibody synthesis in Graves' disease (GD). To investigate this hypothesis, serial serum levels of TSH receptor antibodies, as determined by a recently developed immunoprecipitation assay (IPA), were measured in 13 patients with GD before and after subtotal(More)
We evaluated the benefits of bilateral deep cervical plexus block regional anesthesia in healthy and high risk patients undergoing thyroid and parathyroid surgery and assessed its effects on respiratory function. Twenty-one patients undergoing thyroid and parathyroid operations were studied. Bilateral superficial and deep plexus blocks were performed in all(More)
Electrical impedance plethysmography of the lower leg is now a widely used test for detection of deep vein thrombosis. The origin of the impedance signal is difficult to evaluate in the living subject, and experimental animals have important anatomic differences. A controlled study on human cadavers was therefore undertaken. Conductive and nonconductive(More)
Impedance cardiography has enjoyed widespread interest owing to the promise of noninvasive monitoring of cardiac function. In clinical practice, one factor limiting its use has been the need to use circumferential electrodes. These electrodes can be inconvenient to apply, may interfere with chest tubes or intravenous lines, and can cause additional(More)