A strategy to prevent substance abuse in an academic anesthesiology department.

Substance abuse is the most serious occupational safety issue associated with the practice of anesthesiology, with an incidence as high as 1% per year of training. The Cleveland Clinic's Anesthesiology Institute approached the process from the perspective of active prevention, including specific mandatory education programs for all department personnel on a recurring basis, strengthened procedures for the detection and prevention of diversion of controlled substances, enhanced skill building for detection of impairment, and implemented a multi-faceted drug testing program, including random and "for cause" urine screens, for prevention and early detection of abused anesthetic drugs and other substances of abuse. After 18 months of preparation, a Substance Abuse Prevention Protocol was created, which has been fully implemented as of September 1, 2007.

Use of versant TMA and bDNA 3.0 assays to detect and quantify hepatitis C virus in semen.

Previous findings of hepatitis C virus (HCV) in human semen have been inconsistent. This study attempted to elucidate the presence of HCV in semen from 80 HCV RNA blood plasma positive homeless men using two novel non-PCR based techniques. Semen was frozen immediately upon ejaculation in order to preserve virus quantity.

Relevant patient and tumor considerations for early prostate cancer treatment.

Prostate cancer remains the most commonly diagnosed noncutaneous malignancy in American men. Currently, there are 3 standard treatment options available to men with early prostate cancer: expectant management, radiation therapy, and radical prostatectomy. Although a number of studies have evaluated survival after treatment for early prostate cancer, the optimal choice of therapy for any given patient remains a difficult decision and requires the consideration of a variety of patient and tumor factors.

A rare case of renal hemangioma presenting as polycythemia.

Instances of renal cell carcinoma and erythropoietin-producing renal cysts presenting as polycythemia are well documented. To our knowledge, no case of hemangioma presenting as polycythemia has been reported. We present a case of a 39-year-old man with a 5-year history of polycythemia requiring phlebotomy every 3 months.

Anion gap determination in preeclampsia.

Objective: To determine if the calculated anion gap differs according to presence or absence of hypertension in pregnant women.

Methods: Retrospective data were obtained for 1223 patients who delivered at a community hospital during a 6-month period. Fifty-six (4.