Delayed diagnosis of cardiac amyloidosis in a West African octogenarian.

Left ventricular hypertrophy (LVH) is a common finding on cardiac imaging. Although there are multiple aetiologies for LVH, hypertension is frequently a presumed cause due to its high prevalence in the African region. Establishing a specific cause of LVH however requires thorough clinical evaluation with multimodality cardiac imaging playing a key role in the diagnostic pathway.

Understanding the Experience of Osteoporosis Risk in Bariatric Surgical Patients.

Despite what is known about risk factors, preventive treatment, and increased prevalence of fragility fractures in post-bariatric surgical patients, little is known about how patient perspectives of osteoporosis risk inform their commitment to bone health. The purpose of this study was to examine the lived experience of osteoporosis risk in people who have had bariatric surgery. Interpretive phenomenology was used to explore osteoporosis from the perspectives of patients who have had bariatric surgery.

Is it Noise? Factors Linked With Sleep Interruption in Hospitalized Patients.

Purpose/aim: The aim of this study was to explore the perceived quality of sleep and sleep disturbances in hospitalized patients.

Design: A prospective descriptive, exploratory, cross-sectional study was conducted at a 172-bed community hospital in Northeast Ohio. A convenient sample of 100 hospitalized patients was recruited from medical/surgical, progressive care, and intensive care units.

Implementation of a Vital Sign Alert System to Improve Outcomes.

Background: Patients at risk for clinical deterioration often show changes in vital signs up to 24 hours before a critical event. Use of modified early warning scores has demonstrated effectiveness in identifying patients at risk for clinical deterioration and improving outcomes.

Local Problem: Documentation of vital signs, timely recognition of clinical deterioration, and compliance with the sepsis bundles remained a challenge.

Low-Dose Methotrexate for the Prevention of Atherosclerotic Events.

Background: Inflammation is causally related to atherothrombosis. Treatment with canakinumab, a monoclonal antibody that inhibits inflammation by neutralizing interleukin-1β, resulted in a lower rate of cardiovascular events than placebo in a previous randomized trial. We sought to determine whether an alternative approach to inflammation inhibition with low-dose methotrexate might provide similar benefit.

Nursing Care of the Patient Undergoing an Anterior Approach to Total Hip Arthroplasty.

The anterior, anterolateral, direct lateral, transtrochanteric, and posterior techniques have historically been the surgical approach to a total hip arthroplasty; however, a forthcoming technique called the direct anterior approach has been demonstrated to produce many patient and physician quality outcomes. These favorable outcomes can include shorter hospital stay, earlier mobility and functionality, decreased medical costs, and increased patient satisfaction scores. Appropriate nursing care during the preoperative, intraoperative, and postoperative phases is essential.

Implementing Evidence-Based Practice to Reduce Infections Following Arthroplasty.

Surgical site infections can have a devastating effect on a patient's morbidity impacting their quality of life and productivity in society. Financial burdens are placed on healthcare organizations because of surgical site infections as well. Evidence has shown that it is a worthwhile endeavor to implement a practice to screen and treat patients who are nasal carriers of Staphylococcus aureus and methicillin-resistant Staphylococcus aureus.

Laparoscopic-assisted colon surgery.

Laparoscopic-assisted colon surgery is a safe alternative to conventional open colectomy. Using the laparoscopic approach, the surgeon uses tools through port sites to mobilize the section of colon to be removed, avoiding a large laparotomy incision. Usually, two to three 5-mm port site are created.

Perioperative care of the patient with Zenker's diverticulum.

There are a variety of surgical approaches to treat the symptomatic patient with a Zenker's diverticulum. Approaches to treat Zenker's diverticula include external excision (i.e.

As others see us, Part 2. Goals and the annual report: a system for performance evaluation.

This systematic approach to an annual performance report can show that laboratory professionals are active outside the physical laboratory as a vital part of the healthcare team. The annual report also provides an opportunity to show the many dimensions of clinical laboratory science and presents evidence of the multifaceted role of the laboratory manager. The annual report shows that employees can be self-directed and creative in goal setting and in achieving goals.