Surgical care improvement project and the orthopaedic patient.

The Surgical Care Improvement Project is a national quality initiative that is evidence based and supports positive patient outcomes. The initiative addresses a variety of interventions that can dramatically reduce the postoperative complications for the surgical orthopaedic patient. At Park Ridge Hospital (PRH), a clinical team performs daily quality rounds to identify orthopaedic patients who fall within these quality initiatives and to identify processes that involve all clinical staff in successfully achieving these initiatives.

Rapid response team approach to staff satisfaction.

Rapid response team (RRT) is a patient care concept that has received nationwide attention as a resource for hospital staff nurses. Once nurses identify a patient who is clinically declining, they call upon the assistance of the RRT member. Within an 800-bed acute care hospital, a job satisfaction survey tool was developed to ask licensed staff on an orthopaedic unit what type of impact the RRT has on their job satisfaction.

The limited role of neuroimaging in determining criminal liability: an overview and case report.

Objective: Studies indicate there is a substantial biological substrate for psychopathic behavior. Neuroimaging techniques have afforded biomedical sciences a means to investigate further how aberrant brain activity or structure may be correlated with psychopathy and violence. This paper will provide an overview of the literature, and then will explore the role of structural and functional MRI brain imaging in the defense of a young adult male charged with kidnapping and rape.

Correlation of high sensitivity C-reactive protein and calcific aortic valve disease.

Objective: To determine whether a difference exists in the levels of high sensitivity C-reactive protein (Hs-CRP) in patients with and without calcific aortic valve disease (CAVD).

Patients And Methods: This cross-sectional study consisted of 110 patients who had undergone echocardiographic examination from January 2005 to February 2006 at our institution. Information on demographic variables, coronary risk factors, and medications was obtained.

Elevated B-type natriuretic peptide level: use with caution in patients with multiple co-morbidities and presenting with dyspnea.

Background And Aim: While the effect of age, gender, body mass index and renal failure on B-type natriuretic peptide (BNP) has been studied individually in different trials, the influence of all these co-morbidities in patients with dyspnea needs to be evaluated. The objective of our study was to examine the effect of age, gender, obesity and co-morbid conditions on the evaluation of higher BNP levels in patients presenting with dyspnea.

Methods: A total of 382 patients admitted with shortness of breath and suspected to have congestive heart failure were included in the study.

Headache response to glyceryl trinitrate in patients with and without obstructive coronary artery disease.

Objectives: To examine the hypothesis that glyceryl trinitrate (GTN) may cause headache in patients with normal coronary arteries more often than in patients with obstructive coronary artery disease (CAD). This simple assessment may aid clinicians in the initial evaluation of chest pain syndrome and possible CAD.

Patients And Methods: 118 patients (66 men and 52 women) with new onset of chest pain were enrolled in this study.

A 29-year-old Harken disk mitral valve: long-term follow-up by echocardiographic and cineradiographic imaging.

An 81-year-old woman was evaluated for prosthetic mitral valve function. She had received a Harken disk mitral valve 29 years earlier due to severe mitral valve disease. This particular valve prosthesis is known for premature disk edge wear and erosion.

Large aneurysms of the ascending aorta and major coronary arteries in a patient with hereditary hemorrhagic telangiectasia.

We describe a 50-year-old man with a history of hereditary hemorrhagic telangiectasia (Osler-Weber-Rendu disease) who presented with chest pain, atrial fibrillation, and congestive heart failure. Echocardiography revealed a large ascending aortic aneurysm accompanied by severe aortic regurgitation and giant coronary artery aneurysms involving the right, left main, left anterior descending, and circumflex coronary arteries. Coronary angiography clearly defined multiple aneurysms involving the aorta and coronary arteries.

Immunological analysis of pleural fluid in post-cardiac injury syndrome.

Post-cardiac injury syndrome (PCIS) is an inflammatory process involving pleura and pericardium secondary to cardiac injury. Even though this clinical entity has been recognised for decades, diagnosis is difficult because of lack of a diagnostic test. Antimyocardial antibody titre in pleural fluid and serum has been proposed to have diagnostic value.

Involving patients in decisions regarding preventive health interventions using the analytic hierarchy process.

Practice guidelines that recommend active patient involvement in decisions about preventive health interventions are becoming increasingly common. These decisions frequently involve difficult trade-offs between competing risks and benefits that require easily accessible information about the expected outcomes, superb doctor-patient communication, and effective integration of objective outcome data with individual values and preferences. Successful implementation of recommendations for shared decision-making in preventive health care will require the development of efficient methods for making these complex decisions in busy practice settings.

Antiepileptic drug therapy: clinical laboratory significance.

When evaluating a patient who is taking an antiepileptic medication, it is important for the emergency physician to correlate the clinical presentation with the antiepileptic drug level. Therapeutic ranges have been suggested for most antiepileptic medications, but these must be interpreted in light of clinical efficacy and patient tolerance. When considering the efficacy of anti-epileptic medications, it is necessary to consider the patient's unique metabolism, side-effect tolerance, and overall response to therapy.

Acute stroke.

Disruption of cerebral blood flow may influence brain energy metabolism to produce reversible or irreversible neurologic deficits. The emergency physician is in a unique position to provide timely treatment during the first few hours of an acute stroke. He or she must be facile with unique pharmacologic and non-pharmacologic treatment designed for the stroke patient concerning ventilation, blood pressure, and circulation.

Nonmelanotic malignant skin tumors of the hand.

Squamous cell and basal cell carcinomas, the common nonmelanotic skin tumors, are the most frequent malignancies to occur in the hand. In spite of a rising incidence, these tumors are only occasionally seen by the hand surgeon because of their overall rarity. Untreated lesions are locally destructive and may cause functional deficits and death by way of metastasis.

Automated pattern analysis of corneal endothelium.

A proper understanding of the endothelial cell morphology of the cornea is of great significance to the corneal surgeon. Specular microscopy allows direct visualization of endothelial cell morphology and a proper analysis of these data needs automated computerized type of systems. Automated pattern analysis seems to offer a good option in this direction.