Clinical experience with a circumferential clip-based vascular closure device in diagnostic catheterization.

Background: The StarClose Vascular Closure System (Abbott Vascular Devices, Redwood City, California) utilizes a small, flexible nitinol clip to complete a circumferential, extravascular closure of the femoral arteriotomy site. The StarClose is an investigational device in the United States, limited by Federal law to investigational use. The StarClose is CE Mark approved.

Laparoscopic repair for groin hernias.

So where do things stand in 2003? Laparoscopic herniorrhaphy appears to result in less postoperative pain (acute and chronic) and in a shorter convalescence and an earlier return to work, compared with the open repair. It can be performed safely and with a low recurrence rate. However, it takes longer to do, is more difficult to learn, and costs more, all reasons why it is not more commonly performed.

Laparoscopic transcystic sphincter of Oddi manometry is not affected by carbon dioxide pneumoperitoneum.

Sphincter of Oddi (SO) dysfunction as a potential cause of chronic acalculous cholecystitis (CAC) has not been studied in cases for which intraoperative SO manometry was used during laparoscopic cholecystectomy. In this study, we evaluated the effects of carbon dioxide pneumoperitoneum on laparoscopic transcystic SO manometry. In 27 patients with CAC, transcystic SO manometry had been attempted during laparoscopic cholecystectomy.

Putting patient-focused care into practice.

Patient-focused care relies on a framework supported by staff member empowerment and cross training, decentralization, patient care teams, and computerization. Decisions are made based on what is best for the patient rather than what is best for the staff members. How patient-focused care is applied is influenced by the basic structure, beliefs, and values of the institution.

Heat illness.

Heat stroke is reviewed in detail. Particular attention is paid to diagnosis and current emergency department treatment, and a brief overview of pathophysiology is included. Early complications, with recommendations for prevention and management, are described.

Survey of pharmacy directors' experience with staff vacancies and recruitment.

Hospital pharmacy directors were surveyed in September 1987 about staff pharmacist turnover, recruitment, and retention. Questionnaires were mailed to pharmacy directors at 541 hospitals in the United States. Three hundred thirty-nine questionnaires were returned (62.