Provision and standards of care for treatment and follow-up of patients with Autoimmune Hepatitis (AIH).

Background: Autoimmune hepatitis (AIH) is a substantial UK health burden, but there is variation in care, facilities and in opinion regarding management. We conducted an audit of service provision and care of patients with AIH in 28 UK hospitals.

Methods: Centres provided information about staffing, infrastructure and patient management (measured against predefined guideline-based standards) via a web-based data collection tool.

Johan Forceps As a Knot Pusher for Extracorporeal Roeder Knot: An Inexpensive Alternative to an Endoloop Ligature in Laparoscopic Appendicectomy.

Securing of the appendix stump is one of the key steps in performing laparoscopic appendicectomy (LA). This can be achieved by a variety of methods including endoloops, stapler, and clips. An alternative technique, previously described by authors, is the use of Johan forceps as a knot pusher, to deploy an extracorporeal Roeder knot at the base of appendix.

Templating Hip Arthroplasty.

Background: Different methods have been developed and employed with variable degrees of success in pre-operative templating for total hip arthroplasty. Preoperative templating, especially digital templating, has been claimed to have increased the effectiveness of total hip arthroplasty by improving the precision of prediction of prosthetic implant size.

Aims: The overall aim of this systematic review is to identify whether the use of pre-operative templating in total hip arthroplasty procedures has resulted in increased accuracy, reliability and precision of the procedure.

Automatic fall detectors and the fear of falling.

We studied the effect of automatic fall detection units on the fear of falling. Participants were community alarm users living in the community aged over 75 years or those aged 60-74 years who had experienced a fall in the previous six months. Of those approached, 31% consented to take part; the main reason given for potential participants declining involvement was that they were happy with the technology they already had.

Implementing nursing clinical indicators.

Clinical indicators state desirable patient outcomes using evidence-based targets. Locally based indicators give professional staff ownership of the process of audit, and the programme can be adapted to the local circumstances.

Acupuncture and other alternative therapies in rheumatoid arthritis.

Increasing use of alternative therapies is being reported in many areas of health care, particularly in those specialties in which conventional medicine can offer no complete cures. This article examines what is known about the current use of alternative therapies, and acupuncture in particular, by patients with rheumatoid arthritis.

Intramuscular ketamine in a parturient in whom pre-operative intravenous access was not possible.

We describe the management of a 23-yr-old woman with extreme needle and mask phobia, presenting for an emergency Caesarean section for fetal distress. She also suffered from spina bifida cystica with no sensation from mid thigh. Regional anaesthesia, rapid sequence induction, and gaseous induction were not possible.

A high uptake eye and foot screening service for an urban population.

Aims: A community diabetes eye screening service using slit-lamp biomicroscopy and colour fundus photography was set up in 1993 at the Barnsley District General Hospital Diabetes Centre with a foot screening service being added in 1994. The service is available for all diabetic patients in the Barnsley health district (encompassing 220,000 people). After 4 1/2 years, a survey was carried out to establish the uptake of this service.

Health service indicators for radiology departments: how meaningful are they?

The Health Service Indicator (HSI) for Radiology Services in the UK is represented by a cost per case figure based on annual expenditure and workloads in individual departments. These show significant variations betweeen departments for a number of predictable reasons. Detailed analysis shows good correlation between population-based radiology costs and workloads and that departments with low cost per case values have above average workloads.

Implementation of a PC-based integrated control system for children.

Children with severe physical disabilities often require a range of technological devices to aid them with the fundamental tasks carried out in everyday life. These tasks areas may include mobility, communication, environment control and computer access for education. The most efficient, and often the most cost-effective, way of providing for these requirements is by the provision of a single, integrated system tailored to the individual's needs and abilities.