Recovery from kidney failure associated with chronic thromboembolic pulmonary hypertension following pulmonary thomboendarterectomy.

The occurrence of renal failure in pulmonary hypertension (PH) is an ominous sign and implies excessive adverse hemodynamic factors. Pharmacologic agents to treat the PH are the mainstay of management, whereas diuretics assist in management of fluid overload. However, when such measures fail, dialysis and ultrafiltration (UF) become necessary to manage progressive azotemia and hypervolemia.

Identification of infants at risk for autism spectrum disorder and developmental language delay prior to 12 months.

Studies have shown an increased head circumference and the absence of the head tilt reflex as possible risk factors for autism spectrum disorder, allowing for early detection at 12 months in typically developing population of infants. Our aim was to develop a screening tool to identify infants prior to 12 months at risk for autism spectrum disorder and developmental learning delay, not affected by literacy or primary parental language, and provide immediate determination of risk for autism spectrum disorder. An abrupt head circumference acceleration and the absence of head tilt reflex by 9 months were used to identify infants at risk for autism spectrum disorder.

Integrating computerized primitives and annotated video patterns: a proposed model for autism diagnosis and research.

The use of computerized, digital video as a means for interactive data capture has been suggested as an alternative to direct observation of behavior. The appeal of observational measures is that they are presumed to be less vulnerable to potential biases from informants, such as parents or teachers, and permit more individualized assessment that may be lost with the use of rating scales. As a potential tool for long-term, automated observation and analysis.

Data capture of transdermal glucose monitoring through computerized appliance-based virtual remote sensing and alert systems.

Monitoring of blood glucose levels is important to persons with diabetes or pre-diabetic, abnormal glucose indications. Such individuals must determine when insulin is needed to reduce glucose levels in their bodies, or when additional glucose must be administered to raise levels. A conventional technique used by many diabetics to personally monitor their glucose level includes the periodic drawing of blood, the application of blood to a test strip, and determination of blood glucose level using calorimetric, electrochemical, or photometric detection.

Clinical variability and novel neurodevelopmental findings in 49, XXXXY syndrome.

49, XXXXY is a rare chromosomal syndrome due to double nondisjunction of the replicating X chromosome. Considered a severe variant of XXY or Klinefelter syndrome, boys with this chromosome constitution are assumed to have severe mental retardation (MR) in addition to craniofacial, genital, endocrine, and heart abnormalities. Here, we present a multidisciplinary analysis including the clinical and neurobehavioral aspects of this condition in 20 boys with 49, XXXXY who share a common phenotype and neurobehavioral profile.

Assessing managed care market variation in reports of coding accuracy.

The implementation of larger, faster and more comprehensive databases in healthcare delivery settings is an emerging outgrowth of evidence-based medicine. This study seeks to assess, at a national level, the degree of uniformity across markets in utilization and management of coded medical information. Implications for managers and policymakers, related to comparative managed care data benchmarks, are reviewed.

Manager's reports of variation in coding accuracy across U.S. oncology centers.

Advances in high-speed data processing capabilities, and the increasing reliance on information systems in comparative data assessment, are creating greater dependence on information systems, with a related need for more timely assessment of coding quality. Assessing the accuracy of coded and classified data becomes critical as the implementation of government compliance management requirements, along with the growing adoption of evidence-based medicine in error detection, serve to challenge healthcare researchers to consider the quality of coded data in management assessments. The implementation of larger, faster and more comprehensive databases in healthcare delivery settings is one response to this changing environment, but at a national level there will need to be some degree of uniformity in their utilization and management, if researchers are expected to rely on comparative benchmarks to fully assess organizational performance.

Information in medical decision making: how consistent is our management?

Background: The use of outcomes data in clinical environments requires a correspondingly greater variety of information used in decision making, the measurement of quality, and clinical performance. As information becomes integral in the decision-making process, trustworthy decision support data are required.

Methods: Using data from a national census of certified health information managers, variation in automated data quality management practices was examined.