Advocacy: the time for involvement is now.

The American Hospital Association has targeted 1994 for its national advocacy campaign, which is called "Health Care '94: Shaping Tomorrow Today." Health care educators have an important opportunity to participate in the AHA advocacy efforts and to play a role on the local level, perhaps by assisting their institutional campaigns. In order to be effective, they must be (1) informed about national issues and reform efforts, and (2) committed to participating.

Laparoscopic hernia repair: a preliminary report.

Advances in laparoscopic technique have provided the opportunity to perform preperitoneal herniorrhaphy and potentially avoid the morbidity associated with open techniques. From January 1991 to May 1992, two primary surgeons repaired 63 inguinal hernias (42 indirect, 20 direct, 1 femoral) on 48 patients using a standardized laparoscopic technique. The hernia defect was visualized laparoscopically, and the peritoneum anterior to the defect was incised.

Safety, efficacy, cost, and morbidity of laparoscopic versus open cholecystectomy: a prospective analysis of 228 consecutive patients.

Laparoscopic cholecystectomy has become the procedure of choice in most hospitals for the resolution of surgically treatable gallbladder disease. Few reports address the results of laparoscopic cholecystectomy in comparison to open cholecystectomy during the same time interval within the same institution. One hundred ninety-six laparoscopic cholecystectomies were performed from April 1990 through February 1991.

Laparoscopic inguinal herniorrhaphy in a swine model. Third place winner of the Conrad Jobst Award in the Gold Medal paper competition.

A simplified method of laparoscopic inguinal herniorrhaphy using prosthetic materials was evaluated in a swine hernia model. The goals of this study were to determine 1) effectiveness of repair in a rapidly growing animal, 2) effectiveness and extent of adhesion formation of different prosthetic materials, 3) the effect of repair on testicular growth, and 4) histologic effects on the hernia site and surrounding structures. In a prospective randomized study, 30 juvenile male swine (average, 23 kg) with 35 congenital indirect inguinal hernias underwent laparoscopic herniorrhaphy using one of three prosthetic materials: Group 1 (polytetrafluoroethylene/Gore-Tex), N = 10; Group 2 (polypropylene mesh/Marlex), N = 10; Group 3 (polypropylene mesh/Prolene), N = 10.

Continuous 12-lead electrocardiograph monitoring in the emergency department.

Many patients presenting to the emergency department with suspected acute myocardial infarction have an initial electrocardiogram (ECG) non-diagnostic for acute injury or ischemia. Continuous ST segment monitoring devices have been used by physicians in the past to diagnose ischemia in the ambulatory outpatient population and to identify coronary occlusion in postthrombolytic and postsurgical patients. We report three patients with suspected acute myocardial infarction who underwent real-time continuous 12-lead ST segment monitoring with frequent serial ECGs on a microprocessor-controlled device during their initial emergency department evaluation.

On-site facilities. LIFE FORCE's decision to build.

The size and cost of an on-site maintenance and operations facility will vary greatly depending on the size and location of the structure. The decision to build such a facility must involve an effective feasibility study to evaluate the actual needs and requirements of the air medical program in association with the budgetary constraints of the sponsoring hospital.

Corynebacterium equi peritonitis in a patient receiving peritoneal dialysis.

Our patient represents the first reported case of peritonitis due to C equi. He had no known exposure to farm or domestic animals, and no evidence of underlying systemic immunodeficiency. After relapse, the patient was successfully treated with vancomycin, and catheter removal was not necessary.