Faculty Bibliography

They did find significant variations in death rates among several thousand patients who underwent bypass operations in New England and Philadelphia hospitals. But the factors responsible for such differences could not be identified, said the authors of the studies being reported today in The Journal of the American Medical Association. One of the studies reported today involved all 3,055 bypass operations carried out from 1987 to 1989 by the 18 surgeons in the five hospitals that do such procedures in Maine, New Hampshire and Vermont. Factors like advanced age, smaller physical size, being sick from other diseases, and being a woman were strong predictors of deaths after bypass surgery in this study, as it has been in others. But such factors did not account for the differences in death rates, according to the research team led by Dr. Gerald O'Connor of Dartmouth-Hitchcock Medical Center in Hanover, N.H

Two medical studies reported in the Journal of the AMA appear to challenge current medical beliefs on why death rates for heart bypass recipients vary among surgeons and hospitals

One of the studies reported Wednesday involved all 3,055 bypass operations carried out by the 18 surgeons in the five hospitals that do such procedures in Maine, New Hampshire and Vermont. The surgeons and hospitals cooperated in the study, which covered operations performed from July 1, 1987, through April 15, 1989. Factors such as advanced age, smaller physical size, being sick from other diseases, and being a woman were strong predictors of deaths after bypass surgery in this study, as it has been in others. But such factors did not account for the differences in death rates among the hospitals and surgeons, the research team headed by Dr. Gerald T. O'Connor of Dartmouth-Hitchcock Medical Center in Hanover, NH, reported

One of the studies involved all 3,055 bypass operations carried out from July 1, 1987, through April 15, 1989, by the 18 surgeons in the five hospitals that do such procedures in Maine, New Hampshire and Vermont. The study was conducted by a team headed by Dr. Gerald T. O'Connor of Dartmouth-Hitchcock Medical Center in Hanover, N.H. Factors such as advanced age, smaller physical size, being sick from other diseases and being a woman were strong predictors of deaths after bypass surgery in this study, as it has been in others. But such factors did not account for the differences in death rates among the hospitals and surgeons. Two categories of patients were studied. One had both heart catheterization and surgery during the same stay. The other entered the hospital only for bypass surgery; catheterization was done earlier. In catheterization, a tube is threaded into an artery and to the heart, where dye is released to obtain an X-ray picture of arteries

Pressed by federal health officials, panels of doctors and dentists are determining which procedures should not be performed by health workers infected with the AIDS virus

The book is Final Exit by Derek Humphry, who is executive director of the Hemlock Society, an organization in Eugene, Ore., that advises on how to commit suicide. Controversy has swirled around publication of the suicide manual because many experts fear that it will be misused by people who are depressed or who might commit murder. Others believe that it is a loud protest against the medical profession for allowing terminally ill patients to suffer. Final Exit is being widely promoted and can be obtained from bookstores by ordering it on the telephone. In dispensing the advice, [Arthur Caplan] said the book presumes that an individual has decided to commit suicide

Controversy surrounding Derek Humphry's book 'Final Exit,' a book that advises terminally ill people how to commit suicide, is discussed. The book hit the No. 1 spot in the hard-cover advice category on the New York Times Best Seller list to be published Aug 18, 1991

'When you have a man and a woman with angina and both in their 50's, a physician often gets the impression that the woman is less apt to accept procedures and is much more prone to say, 'Give me some medication,' ' Dr. Fuster said. 'The practice results in more complicated cases and more difficult surgery,' Dr. [Claude J. Lenfant] said. 'People would have accused you of malpractice if you had done that 20 years ago.' Emergency Surgery 'The question is how can you pinpoint what exactly makes the difference,' said Dr. [Valentine Fuster], the Boston expert. He added: 'When one looks at all the factors that play a role in coronary artery disease, one becomes humbled by the fact that it is so complex.'

After a yearlong investigation showed that a Florida dentist and five of his patients had become infected with the same strain of the AIDS virus, federal and state medical detectives are mounting a fresh probe into how the virus was transmitted. The investigators are even giving serious consideration to the theory - for which there is no present evidence - that [David J. Acer], who died of AIDS last summer, might have deliberately injected them with the human immunodeficiency virus. The most talked about explanation - that Acer transmitted the virus while having sex with patients under anesthesia - has been ruled out. No infected patient had general anesthesia and all denied having sex with the dentist