Communicating with patients using a new vitamin B12 deficiency leaflet.

The aim of this quality improvement project was to improve patients' knowledge about their vitamin B12 deficiency by developing an information leaflet and engaging nursing staff in providing this educational tool to patients with the condition. Following two 'plan, do, study, act' cycles to test and improve implementation of the leaflet, the nursing team met the goal of 100% compliance with providing educational information to patients. An increase in patient knowledge following provision of the leaflet was predicted, and achieved.

Patient safety culture in maternity units: a review.

Purpose: The purpose of this paper is to summarize studies that have examined patient safety culture in maternity units and describe the different purposes, study designs and tools reported in these studies while highlighting gaps in the literature.

Design/methodology/approach: Peer-reviewed studies, published in English during 1961-2016 across eight electronic databases, were subjected to a narrative literature review.

Findings: Among 100 articles considered, 28 met the inclusion criteria.

Illusion or delusion--Lean management in the health sector.

Purpose: There has been considerable interest in the implementation of practices imported from manufacturing into healthcare as a solution to rising healthcare spending and disappointing patient safety indicators. One approach that has attracted particular interest is Lean management and the purpose of this paper is to engage with this topic.

Design/methodology/approach: Secondary research.

Physiologically relevant changes in serotonin resolved by fast microdialysis.

Online microdialysis is a sampling and detection method that enables continuous interrogation of extracellular molecules in freely moving subjects under behaviorally relevant conditions. A majority of recent publications using brain microdialysis in rodents report sample collection times of 20-30 min. These long sampling times are due, in part, to limitations in the detection sensitivity of high performance liquid chromatography (HPLC).

Effects of stress on nursing integrity.

This article looks at the relationship between stress, nursing integrity and patient care. It has been argued that the professional integrity of nurses has been eroded and consequently they have become more susceptible to anxiety, stress and exhaustion, potentially affecting care delivery. The authors suggest that the goal of providing high professional standards is threatened by increased service demands, and there is therefore a need for nurses to develop effective coping strategies to manage stress resulting from competing tensions in the workplace.

A necessary change: the transfer of care from hospital to community.

While there is ample evidence for the benefits of diverting resources from hospital delivery out to the community in terms of improved patient safety, very little is known about the impact on a healthcare provider's efficiency and output (Øvretveit, 2009).

Cancelled procedures: inequality, inequity and the National Health Service reforms.

Using data for every elective procedure in 2007 in the English National Health Service, we found evidence of socioeconomic inequality in the probability of having a procedure cancelled after admission while controlling for a range of patient and provider characteristics. Whether this disparity is inequitable is inconclusive.

Cancelled surgeries and payment by results in the English National Health Service.

Objectives: To model the frequency of 'last minute' cancellations of planned elective procedures in the English NHS with respect to the patient and provider factors that led to these cancellations.

Methods: A dataset of 5,288,604 elective patients spell in the English NHS from January 1st, 2007 to December 31st, 2007 was extracted from the Hospital Episode Statistics. A binary dependent variable indicating whether or not a patient had a Health Resource Group coded as S22--'Planned elective procedure not carried out'--was modeled using a probit regression estimated via maximum likelihood including patient, case and hospital level covariates.

Metachronous primary melanoma and lymphoma.

The association of cutaneous melanoma and non-Hodgkin lymphoma has been well documented. We identified 117 patients from the Connecticut Tumor Registry between 1973 and 2002 with diagnoses of both melanoma and non-Hodgkin lymphoma. Charts were reviewed based on patients identified with these diagnoses in the Tumor Registry at Yale-New Haven Hospital between 1926 and 2004.

Recombinant factor VIIa: hemostatic adjunct in the coagulopathic burn patient.

Introduction: Recombinant factor VIIa (rFVIIa; NovoSeven) is well recognized as an effective hemostatic agent in the management and prophylaxis of patients with hemophilia. We report here the successful use of rFVIIa in a coagulopathic burn patient.

Methods: A 63-year-old man was admitted with significant upper-body burns in a total body surface area of 60%.

Utilization of postcranioplasty skull molding caps in the treatment of Apert syndrome.

Patients with Apert syndrome have bilateral coronal craniosynostosis as one of their many distinguishing features. Surgical correction of this deformity is the mainstay of treatment. Abnormal widening of the skull base progresses despite cranioplasty.

Transcriptional regulation of bone marrow thrombopoietin by platelet proteins.

Platelet production is regulated primarily by the cytokine thrombopoietin (TPO). Although TPO is expressed in several different tissues, only in the bone marrow has the level of expression been reported to increase in response to reduced numbers of platelets. In these studies, we demonstrate that platelet granule proteins are able to transcriptionally repress TPO mRNA expression in a marrow stromal cell line as well as in primary bone marrow stromal cell cultures.

Prosthetic vascular graft infection: a multi-center review of surgical management.

A multi-center retrospective review of major prosthetic graft infection outcomes was undertaken to determine graft preservation and limb salvage rates. The management of infected prosthetic vascular grafts continues to be controversial. The purpose of this study was to review the surgical management of major extracavitary prosthetic vascular graft infections and to correlate the outcomes on the basis of bacteriology and grade.

Staged arterial embolization and surgical resection of a giant splenic artery aneurysm.

Splenic artery aneurysms (SAAs) are increasingly being diagnosed as incidental findings. Management modalities include operative treatment, percutaneous embolization, laparascopic ligation, and observation. Giant SAAs larger than 8 cm are a rare entity.

Managing extracavitary prosthetic vascular graft infections: a pathway to success.

Prosthetic vascular graft infections portend grave consequences if not treated expediently. Despite the low incidence of infection, the potential for limb loss or death greatly magnifies this complication. The surgical management of prosthetic graft infections has evolved over the last 2 decades.

Necrobiosis lipoidica resulting in squamous cell carcinoma.

Necrobiosis lipoidica is a chronic degenerative disease of dermal connective tissue, of unknown etiology, which occurs mostly in diabetic patients. It may occasionally be complicated by squamous cell carcinoma. Since this combination is rare, a high index of suspicion is necessary to establish the diagnosis.

Endovascular repair of transplant nephrectomy external iliac artery pseudoaneurysm.

The formation of a pseudoaneurysm at the site of transplant nephrectomy is a rare complication, having been reported only six previous times in the literature. Possible causes of this occurrence include infection or rejection of the anastomotic remnant. Diagnosis of the pseudoaneurysm with radiological imaging is necessary.

Head and neck angiosarcomas.

Angiosarcoma of the head and neck is a rare and lethal neoplasm. Data from the Connecticut Tumor Registry was analyzed for all head and neck angiosarcomas between 1980 and 2001. The authors also present the first reported case of familial angiosarcoma of the head and neck region.