Spontaneous bacterial peritonitis--in-hospital mortality, predictors of survival, and health care costs from 1988 to 1998.

Objectives: Spontaneous bacterial peritonitis (SBP) is a complication of end-stage liver disease with a reported mortality of 30-50%. In this study, we investigated the outcome of all patients admitted to Maryland hospitals with SBP from 1988 to 1998. Main outcomes considered included trends in survival rates over time, changes in the length of stay, total health care costs, and variables that predicted survival rates.

Reduced left ventricular dimension and normalized atrial natriuretic hormone level after repair of aortic coarctation in an adult.

Although unusual in the older patient, coarctation of the aorta can be an occult cause of cardiomyopathy. This report describes a 53-year-old man with new-onset heart failure symptoms, global left ventricular (LV) dysfunction, and underlying aortic coarctation. Surgical correction resulted in reduced LV size, resolution of symptoms, and normalization of atrial natriuretic hormone levels.

Measurement of the validity of utility elicitations performed by computerized interview.

Objectives: The authors evaluate a measure of the validity of utility elicitations and study the potential effects of invalid elicitations on population utility values.

Methods: The authors used a computerized survey to describe and measure preferences for three common side-effects of anti-psychotic drugs (tardive dyskinesia [TD], akathesia [AKA], pseudo-parkinsonism). The authors compared the validity of elicitations in 41 healthy volunteers to 22 schizophrenic patients.

The side effects of antipsychotic drugs and patients' quality of life: patient education and preference assessment with computers and multimedia.

Determining the relative value of novel antipsychotics such as clozapine requires measures of the utility of their different side-effect profiles. Many of these side effects (SE) are complex and difficult to describe adequately. Schizophrenic patients are also difficult to interview reliably.

Designing for hospital growth.

This article describes and illustrates a planning methodology for accommodating the unpredictable pattern of hospital growth. The methodology is based on four concepts: overstated planning targets for every department; a circulation skeleton; a zoning pattern providing separate zones for major hospital functions; and a deliberate effort to design flexible, expandable physical space.