Determination of Unnecessary Blood Transfusion by Comprehensive 15-Hospital Record Review.

Background: Although unnecessary blood component transfusions are costly and pose substantial patient risks, the extent of unnecessary blood use in a community hospital setting has not been systematically measured.

Methods: A 15-hospital observational analysis was performed using comprehensive retrospective review. Approximately 100 encounters (x¯ = 103.

Optimizing utilization of beta-lactam surgical prophylaxis through implementation of a structured allergy assessment tool in a presurgical clinic.

In patients with β-lactam allergies, administration of non-β-lactam surgical prophylaxis is associated with increased risk of infection. Although many patients self-report β-lactam allergies, most are unconfirmed or mislabeled. A quality improvement process, utilizing a structured β-lactam allergy tool, was implemented to improve the utilization of preferred β-lactam surgical prophylaxis.

Multi-institutional survey on imaging practice patterns in pancreatic ductal adenocarcinoma.

Purpose: To study the practice patterns for performance and interpretation of CT/MRI imaging studies in patients with pancreatic ductal adenocarcinoma (PDAC) at multiple institutions using a survey-based assessment.

Methods: In this study, abdominal radiologists/body imagers on the Society of Abdominal Radiology disease-focused panel for PDAC and from multiple institutions participated in an online survey. The survey was designed to investigate the imaging and reporting practice patterns for PDAC.

Obesity May Be Protective against Severe Perineal Lacerations.

Objective. To determine if there is an association between BMI and 3rd- or 4th-degree perineal lacerations in normal spontaneous and operative vaginal deliveries. Study Design.

Iron deficiency anemia in women: a practical guide to detection, diagnosis, and treatment.

Introduction: Iron deficiency anemia (IDA) remains a widely underdiagnosed and unappreciated women's health issue, affecting women of all ages. Despite the fact that IDA is easily diagnosed and treated, it continues to be a major public health issue. The World Health Organization estimates that 30% of nonpregnant and more than 42% of pregnant women have anemia.

Improved obstetric safety through programmatic collaboration.

Healthcare safety and quality are critically important issues in obstetrics, and society, healthcare providers, patients and insurers share a common goal of working toward safer practice, and are continuously seeking strategies to facilitate improvements. To this end, 4 New York City voluntary hospitals with large maternity services initiated a unique collaborative quality improvement program. It was facilitated by their common risk management advisors, FOJP Service Corporation, and their professional liability insurer, Hospitals Insurance Company.

Iron deficiency anemia in women across the life span.

Anemia is a global health issue with disproportionately high prevalence in women. In addition to being an independent risk factor for decreased quality of life and increased morbidity and mortality, anemia in women has been linked to unfavorable outcomes of pregnancy and other issues for children born to anemic women. Iron deficiency is the leading cause of anemia in many populations.

Feasibility of remote CT colonography at two rural Native American medical centers.

Objective: Fort Defiance Indian Hospital and Tuba City Regional Health Care Center are two rural hospitals with limited availability of optical colonoscopy (OC) and other methods of colorectal cancer screening. Our goals were to determine whether adequate examinations could be obtained with remote supervision after brief onsite instruction and to share lessons learned in our experience with a remote CT colonography (CTC) screening program.

Materials And Methods: After brief onsite instruction, including performing a CTC examination on a volunteer to train the CT technologists, both sites began performing CTC using standard bowel preparation, fecal tagging, automatic insufflation, and low-dose technique.

Comparison of the accuracy of CT volume calculated by circumscription to prolate ellipsoid volume (bidimensional measurement multiplied by coronal long axis).

Rationale And Objectives: Tumor volume is one of the most important factors in evaluating the response to treatment of patients with cancer. The objective of this study was to compare computed tomographic (CT) volume calculation using a semiautomated circumscribing tracing tool (manual circumscription [MC]) to prolate ellipsoid volume calculation (PEVC; bidimensional measurement multiplied by coronal long axis) and determine which was more accurate and consistent.

Materials And Methods: The study included six patients with nine neoplasms, six phantoms, and two radiologists.

Detection, evaluation, and management of anemia in the elective surgical patient.

The prevalence of anemia in elective surgical patients may be as frequent as 75% in certain populations. A national audit demonstrated that 35% of patients scheduled for joint replacement therapy have a hemoglobin <13 g/dL on preadmission testing. Standard practice currently consists of preadmission testing 3 to 7 days before an elective operative procedure, precluding the opportunity to effectively evaluate and manage a patient with unexpected anemia.

Hepatic cavernous hemangioma with atypical peripheral rim activity on hepatic blood pool imaging.

Hemangioma is the most common benign liver tumor. Hepatic blood pool imaging is an effective technique with a specificity approaching 100%. Typically, hemangiomas are completely filled on hepatic blood pool imaging.

Pulmonary artery compression by a saphenous vein graft aneurysm and contrast echocardiography using an agitated mixture of ten percent air, ten percent blood, and ten percent saline.

This case illustrates the use of intravenous injection of an agitated mixture of 10% air, 10% blood, and 80% saline during intraoperative transesophageal echocardiography in a patient with a saphenous vein graft aneurysm compressing the main pulmonary artery.

Practice pattern variability for myocardial revascularization: impact on resource use across 24 centers.

Objective: To determine the predictors of hospital length of stay (LOS) after elective uncomplicated coronary artery bypass graft surgery.

Design: Retrospective analysis of the EPI-1 database, 1991-1993.

Setting: Multicenter; 24 academic, private, federal, and health maintenance institutions.