Care delivery team composition effect on hospitalization risk in African Americans with congestive heart failure.

The care delivery team (CDT) is critical to providing care access and equity to patients who are disproportionately impacted by congestive heart failure (CHF). However, the specific clinical roles that are associated with care outcomes are unknown. The objective of this study was to examine the extent to which specific clinical roles within CDTs were associated with care outcomes in African Americans (AA) with CHF.

Quantifying care delivery team influences on the hospitalization outcomes of patients with multimorbidity: Implications for clinical informatics.

The primary objective was to quantify the influences of care delivery teams on the outcomes of patients with multimorbidity. Electronic medical record data on 68,883 patient care encounters (i.e.

COVID-19 Is Connected with Lower Health Literacy in Rural Areas.

The relationship between social determinants of health (SDoH) and health outcomes is established and extends to a higher risk of contracting COVID-19. Given the factors included in SDoH, such as education level, race, rurality, and socioeconomic status are interconnected, it is unclear how individual SDoH factors may uniquely impact risk. Lower socioeconomic status often occurs in concert with lower educational attainment, for example.

Surgeon-performed touch preparation of breast core needle biopsies may provide accurate same-day diagnosis and expedite treatment planning.

Background: We aimed to determine the accuracy of surgeon-performed touch-preparation cytology (TPC) of breast core-needle biopsies (CNB) and the ability to use TPC results to initiate treatment planning at the same patient visit.

Methods: A single-institution retrospective review of TPC results of ultrasound-guided breast CNB was performed. All TPC slides were prepared by surgeons performing the biopsy and interpreted by the pathologist.

Separation of the Baragwanath craniopagus twins.

A case of craniopagus twins is presented. Large contralateral flaps were used to cover the bony defect and exposed brain. Details of the planning and problems are discussed.

Somatosensory evoked potentials quantify clinical improvement of cerebral vasospasm after intravenous administration of nimodipine.

The calcium antagonist nimodipine (Nimotop; Bayer AG Leverkusen) has been shown to prevent cerebral vasospasm after aneurysm surgery. Ten patients with clinical and angiographic evidence of vasospasm showed accompanying delays in central conduction time, quantified by somatosensory evoked potential measurements, but nimodipine infusion markedly improved neurological status and level of consciousness in all cases within 10-60 minutes. Conduction time was simultaneously reduced on the affected side.

Transclival penetrating injury.

A case of a stab wound of the cranium with a retained knife blade is presented. The blade had an unusual course through the base of the skull--the point of the knife penetrated the clival line to end in the posterior fossa. Although the blade was in close proximity to the basilar artery, it was judged safe to extract the knife by blind removal.

Testicular function in patients with spinal cord damage.

Vaying degrees of testicular dysfunction are found in men with traumatic spinal cord damage. Eighteen paraplegic men have been studied and the gonadotropin response to luteinizing hormone-releasing hormone (LRH) measured. Basal serum testosterone estimations were made and in eight of the patients testicular testosterone reserve was assessed by the testosterone response to human chorionic gonadotropin (HCG).

Selective arterial embolization of the brain in an inoperable arteriovenous malformation in the thalamus. A case report.

The embolization of an inoperable arteriovenous malformation of the brain using gelatin foam strips via the Seldinger technique is described. Subsequent operative ligation of the major feeding vessels was performed, with an excellent postoperative result.

Cerebrospinal fluid acid-base balance in patients with severe injuries living at an altitude of 1 660 metres.

Cerebrospinal fluid (CSF) acid-base balance in 40 control subjects and 40 patients with head injuries was studied at an altitude of 1 660 m. The patients with head injuries showed a significantly lower CSF pH associated with a fall in CSF bicarbonate and an elevation of CSF lactic acid. The cause of these observations is unclear, but it is proposed that this may be related to the relative hypoxaemia associated with an altitude of 1 660 m.

Stab wounds of the skull.

Sixteen cases of penetrating stab wounds of the head, where the knife blade has still been in situ on arrival at hospital, are presented. The indications for cerebral angiography, to establish vascular injury, and the spectrum of presentation are discussed. A technique of safe removal is described.

Treatment-orientated classification of subarachnoid haemorrhage.

The prognosis of patients with cerebral aneurysms has improved greatly with modern management, notably hypotensive and steroid therapy and microneurosurgical techniques. A new classification of subarachnoid haemorrhage is discussed to clarify the early management of patients and their referral to specialized units for intensive medical care and curative surgery.