Revisional surgery after colon interposition for benign oesophageal disease.

Although the short-term results of colon interposition for replacement of the oesophagus in part or as a whole are known to be satisfactory, there have been several reports of functional problems associated with total replacement in the long-term follow-up of patients. We have retrospectively studied patients who have required revisional surgery for anatomical and functional sequelae over a 7- to 38-year period. Although the short-segment colon interpositions have been relatively trouble free, several mechanical and functional problems requiring revisional surgery have been encountered in the long-term follow-up of patients who underwent long-segment colon interposition.

Functional and mechanical sequelae of colon interposition for benign oesophageal disease.

Objective: In an attempt to estimate the incidence and severity of the functional and mechanical problems associated with colon interposition for benign oesophageal disease, a retrospective analysis of a single centre experience was undertaken.

Methods: Between 1961 and 1990, a total of 365 patients who survived the postoperative stay in hospital were followed up over 7-38 years and form the basis for this study. Upper gastro intestinal symptoms in these patients were investigated clinically, radiologically, endoscopically and in the oesophageal laboratory.

Limitations of quality control in physicians' offices and other decentralized testing situations: the challenge to develop new methods of test validation.

Traditional quality-control methods are effective for detecting systematic error caused by deterioration of reagents or instruments, but ineffective for detecting sporadic error, which is more likely to occur in low-volume testing environments. Decentralized testing performed by individuals without formal laboratory training has a high potential for sporadic errors. New methods for validating test results, used each time a test result is produced, should replace current quality-control procedures.

Long-term follow-up of children with colon and gastric tube interposition for esophageal atresia.

Background: There are two major methods of esophageal substitution for children born with long-gap esophageal atresia. This study was undertaken to see whether one method of substitution emerged as clearly superior to the other.

Methods: Twenty-four UK children who received a colon transposition for esophageal atresia were compared with 15 US children with esophageal atresia who received a gastric tube.

An evaluation of a whole blood prothrombin analyzer designed for use by individuals without formal laboratory training.

Background: The prothrombin time (PT) test, which is the most common coagulation test used in the outpatient setting, has not been recommended for office laboratory use because it has been technically difficult to perform. Consequently, serious errors in patient care could occur because of an erroneous result. The Coumatrak (E.

A survey of state regulation of testing for drugs of abuse outside of licensed (accredited) clinical laboratories.

We surveyed all 50 states to find out if testing for drugs of abuse outside of clinical laboratories was regulated. In 14 states such regulations existed or were contemplated. Eight additional states indicated that regulatory language does not restrict their oversight of such testing.

Managing bedside glucose testing in the hospital.

The scope and magnitude of bedside testing by personnel without formal laboratory training have recently increased. There has been some question about the reliability of bedside test results produced by nurses, physicians, and other ward staff that are used in clinical decisions. Glucose testing is currently the most widely performed bedside test.