Cutaneous abnormalities and metabolic disturbance of porphyrins in patients on maintenance haemodialysis.

Blistering disorders may occur in patients with chronic renal failure. Photoactive medication may account for some, and others may be attributable to porphyria cutanea tarda (PCT), but most appear idiopathic. Seventy haemodialysis patients at the National Renal Transplant Centre were therefore screened to determine the prevalence of cutaneous disease and to establish a reference range for plasma porphyrins in this population.

Fostering staff ownership of cardiovascular program improvement. Part two: Monitoring variance and outcomes.

The clinical guideline is a living document meant to be updated as clinical knowledge is expanded and program-specific data are generated. This final installment focuses on how programs should measure, manage and report the outcomes of clinical guidelines utilization to remain competitive.