Idiopathic intracranial hypertension: a unifying neuroendocrine hypothesis through the adrenal-brain axis.

The clinical syndrome idiopathic intracranial hypertension (IIH), also termed pseudotumor cerebri, consists of symptoms of headache, nausea, vomiting and visual field defects in combination with findings of papilledema. IIH is more commonly seen in overweight women where the rise in intracranial pressure is putatively a consequence of an endocrine-based disturbance of electrolytes. Less frequently, it can also occur in men and in the pediatric age group.

Outcome and management of isolated severe renal pelvis dilatation detected at postnatal screening.

The aim of this study was to evaluate the incidence and outcome of isolated severe renal pelvis dilatation (RPD; APD>15 View Article and Find Full Text PDF

Outcome and management of isolated moderate renal pelvis dilatation detected at postnatal screening.

The aim of this study was to evaluate the incidence and outcome of isolated moderate renal pelvis dilatation (RPD) [anterior-posterior diameter (APD) 10-15 mm] in an unselected population of 2-month-old infants prospectively followed for up to 12-14 months of life. Isolated moderate renal pelvis dilatation was detected in 282 of the 11,801 (2.4%), infants screened; 240 infants with normal renal ultrasound were enrolled as the control group.

Laboratory quality management: a roadmap.

Laboratories in the United States are subject to so many national, state, and local requirements that it is very complicated to track compliance with every individual organization's listed requirements. What is needed is a roadmap for quality that ensures that each laboratory makes its best contribution to patient care and safety while continually meeting all requirements. This article presents such a roadmap for laboratory quality management that is based on the many and various published laboratory regulations, standards, and accreditation requirements.

Patient safety: getting there from here--quality management is the best patient safety program.

Historical management activities such as quality control (QC) and quality assurance (QA) have not prevented medical errors or patient safety problems related to the laboratory. Reports of laboratory quality assurance activities provide evidence of the need for significant improvement in the total laboratory path of workflow when measured on the Six Sigma scale. The old paradigm has been: people are the cause of medical errors and the solution is to name, blame, and shame them.

Evaluating laboratory performance on quality indicators with the six sigma scale.

Context: Laboratory quality indicator data, most often presented and reported as a percentage of variance, may be misleading, inasmuch as variances, and therefore percentages, appear to be low.

Method: Current data from laboratory quality indicators and national data derived from several years of College of American Pathologists Q-Probes studies were normalized to parts-per-million defects, as commonly practiced in the manufacturing and service industries for benchmarking performance.

Results: Laboratory data in parts-per-million defects demonstrated opportunities for significant improvements in laboratory performance across the total testing process.

Integrating quality management into clinical systems: tools for achieving clinical integration.

This article describes the use of quality systems as a tool for managers of health-care clinical services to establish a common framework across the different disciplines in the continuum of care. Quality systems used internationally in the manufacturing and service sectors are applicable to multidisciplinary clinical systems management because the essential elements of quality are universal. These elements have been redefined into health-care terminology and can be used by clinical systems managers as a basis for implementing a quality system.

Quality pays--in every business!

For the past few years, blood banks within and outside of hospitals have been required to develop a documented quality assurance/quality improvement program to comply with regulator guidelines and accreditation standards. Concerns have been raised that the cost of compliance could exceed any plausible return on this investment. Unfortunately, little data exist in blood bank literature or are currently being captured to support or refute this contention.

Tools for improving quality in the transfusion service.

The initiation of testing for antibody to HIV in the donor blood supply opened a new era of operational, safety, and legal complications for facilities in which transfusion medicine is practiced. Mounting dissatisfaction with increasing incidents of questionable release of blood forced regulators to take tougher actions. Blood banks were surprised and concerned that their practices could no longer effectively ensure blood safety.

A quality system for transfusion medicine ... and beyond.

When more than 500 serious blood banking problems arose in a recent 12-month period, the FDA and AABB knew it was time for a change. The quality system they developed can help the staff of any lab section stand up to the toughest inspection.

Randomized comparison of intravenous versus intracoronary streptokinase for myocardial infarction.

The efficacy of intravenous (i.v.) thrombolytic therapy has not been firmly established in comparison with the intracoronary (i.

Prolongation of the human cardiac monophasic action potential by sotalol.

Sotalol and propranolol are nonselective beta-adrenergic blocking agents. Sotalol at low concentration, unlike propranolol, prolongs the duration of the transmembrane action potential. In a double-blind study, the electrophysiologic effects of intravenous sotalol (0.

Lower-esophageal sphincter function does not determine resting upper-esophageal sphincter pressure.

Records of 269 esophageal motility studies were reviewed to determine the relationship between lower-esophageal sphincter (LES) function and upper-esophageal sphincter (UES) pressure. Average and greatest UES pressures were similar in patients with LES pressures less than 10 mm Hg or greater than 20 mm Hg, and in patients with and without gastroesophageal reflux as determined by an intraesophageal pH electrode test. Although teliologically appealing, the belief that patients with weak lower-esophageal sphincters and gastroesophageal reflux have stronger upper-esophageal sphincters to guard against pharyngeal reflux and aspiration cannot be confirmed by current manometric techniques.