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Donald J. Krogstad

Bio: Donald J. Krogstad is an academic researcher from Harvard University. The author has contributed to research in topics: Streptomycin & Pneumonia. The author has an hindex of 17, co-authored 23 publications receiving 4304 citations.

Papers
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Journal ArticleDOI
TL;DR: If validated by prospective application, the multifactorial index may allow preoperative estimation of cardiac risk independent of direct surgical risk.
Abstract: To determine which preoperative factors might affect the development of cardiac complications after major noncardiac operations, we prospectively studied 1001 patients over 40 years of age. By multivariate discriminant analysis, we identified nine independent significant correlates of life-threatening and fatal cardiac complications: preoperative third heart sound or jugular venous distention; myocardial infarction in the preceding six months; more than five premature ventricular contractions per minute documented at any time before operation; rhythm other than sinus or presence of premature atrial contractions on preoperative electrocardiogram; age over 70 years; intraperitoneal, intrathoracic or aortic operation; emergency operation; important valvular aortic stenosis; and poor general medical condition. Patients could be separated into four classes of significantly different risk. Ten of the 19 postoperative cardiac fatalities occurred in the 18 patients at highest risk. If validated by prospective application, the multifactorial index may allow preoperative estimation of cardiac risk independent of direct surgical risk.

2,476 citations

Journal ArticleDOI
TL;DR: Pneumocystis carinii pneumonia was identified antermortem in 81% of the cases usually by biopsy or needle aspiration of the lung, procedures associated with considerable morbidity and morbidity, and mortality as mentioned in this paper.
Abstract: Analysis of 194 patients with confirmed Pneumocystis carinii pneumonia in the United States over a 3-year period revealed that P. carinii pneumonia occurred almost exclusively in the immunosuppressed host who had a serious underlying disease. The epidemiologic features of pneumocystis pneumonia primarily reflected those of the underlying disease. P. carinii was identified antermortem in 81% of the cases usually by biopsy or needle aspiration of the lung, procedures associated with considerable morbidity and morbidity and mortality. Laboratory identification of P. carinii was usually accurate, but errors resulting from fault staining tecnique occurred. Most patients had been ill less than 2 weeks with bilateral diffuse interstitial pneumonia. Leukopenia (white blood cell count less than or equal to 3,00/mm3) and probably severe hypoxia were negative prognostic factors. Although treatment with pentamidine was effective, the drug frequently cased adverse reactions, particularly impaired renal function, when given with other nephrotoxic agents.

495 citations

Journal ArticleDOI
01 Jul 1978-Medicine
TL;DR: Postoperative cardiac death was significantly correlated with myocardial infarction in the previous 6 months, and Notably unimportant factors included smoking, glucose intolerance, hyperlipidemia, hypertension, peripheral atherosclerotic vascular disease, angina, and distant myocardia.

327 citations

Journal ArticleDOI
TL;DR: The relation between vancomycin clearance and renal function was studied in 22 patients with various degrees of renal functional impairment and in four normal volunteers to construct a nomogram for vancomYcin dosage adjustment.
Abstract: The relation between vancomycin clearance and renal function was studied in 22 patients with various degrees of renal functional impairment and in four normal volunteers. Clearance of vancomycin and creatinine were highly correlated (r = 0.92) among 17 persons not on dialysis. In five dialysis patients vancomycin clearance averaged 0.086 mL/min . kg of body weight (+/- SEM = 0.025). These relations enabled us to construct a nomogram for vancomycin dosage adjustment (based on a mean steady-state serum vancomycin concentration of 15 micrograms/mL) in patients with various degrees of renal functional impairment.

269 citations

Journal ArticleDOI
TL;DR: A number of laboratories have vastly overdiagnosed amebiasis and have reported leukocytes in stools as Entamoeba histolytica, and sporadic cases may be mistakenly diagnosed as ulcerative colitis and inappropriately treated with steroids.
Abstract: Seven investigations of suspected foci of amebiasis between October 1971 and June 1974 lead to three conclusions. [1] A number of laboratories have vastly overdiagnosed amebiasis and have ...

128 citations


Cited by
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TL;DR: The estimated relative risk of death from an increase of one in the comorbidity score proved approximately equal to that from an additional decade of age.

5,388 citations

Journal ArticleDOI
TL;DR: The medical profession should play a central role in evaluating evidence related to drugs, devices, and procedures for detection, management, and prevention of disease.

4,050 citations

Journal ArticleDOI
TL;DR: The ACC and AHA have collaborated with the National Heart, Lung, and Blood Institute and stakeholder and professional organizations to develop guidelines, standards, and policies that promote optimal patient care and cardiovascular health.
Abstract: Preamble and Transition to ACC/AHA Guidelines to Reduce Cardiovascular Risk S50 The goals of the American College of Cardiology (ACC) and the American Heart Association (AHA) are to prevent cardiovascular diseases (CVD); improve the management of people who have these diseases through professional education and research; and develop guidelines, standards, and policies that promote optimal patient care and cardiovascular health. Toward these objectives, the ACC and AHA have collaborated with the National Heart, Lung, and Blood Institute (NHLBI) and stakeholder and professional organizations to develop …

3,524 citations

Book
01 Jan 2001
TL;DR: Without a way of critically appraising the information they receive, clinicians are relatively helpless in deciding what new information to learn and decide how to modify their practice.
Abstract: Medical practice is constantly changing. The rate of change is accelerating, and physicians can be forgiven if they often find it dizzying. How can physicians learn about new information and innovations, and decide how (if at all) they should modify their practice? Possible sources include summaries from the medical literature (review articles, practice guidelines, consensus statements, editorials, and summary articles in "throwaway" journals); consultation with colleagues who have special expertise; lectures; seminars; advertisements in medical journals; conversations with representatives from pharmaceutical companies; and original articles in journals and journal supplements. Each of these sources of information might be valuable, though each is subject to its own particular biases. 1,2 Problems arise when, as is often the case, these sources of information provide different suggestions about patient care. See also p 2093. Without a way of critically appraising the information they receive, clinicians are relatively helpless in deciding what new information

3,305 citations