Waiting time in outpatient care: a study of divergent perspectives

This article documents a survey of waiting time in the outpatient setting. The study was conducted in March 1988 at Gorgas Army Community Hospital, located in the old Panama Canal Zone in the Republic of Panama. Two groups were surveyed. Patients were group one (M = 450) and physicians were group two (N = 55). Of four factors questioned as being the biggest problem in outpatient clinics, group one had a response rate of 83.3% for waiting time, compared with group two's 9.1%. Chi-square analysis was used to test the independence of the two groups at the 1% level of significance. The study reveals that there is a significant difference between patients' and physicians' views of waiting time. This finding provides an enlightening perspective in an effort to understand and to initiate methods to improve waiting time in outpatient medicine.     

Carlos Finlay and yellow fever: triumph over adversity

The eradication of yellow fever in Havana, Cuba, was achieved by a fruitful collaboration between American and Cuban physicians. Carlos Finlay, a Cuban physician who proposed the mosquito-vector theory in 1881, shared his ideas, his publications, and a sample of mosquito eggs with the U.S. Army Yellow Fever Commission. The commission, headed by MAJ Walter Reed, used human volunteers to confirm Finlay's theory. MAJ William Gorgas adopted mosquito-control measures in his sanitation program and, within 6 months, yellow fever was controlled in Havana for the first time. Finlay held fast to his ideas despite incredulity and ridicule. His tenacity and scientific honesty vindicated his ideas about yellow fever.     

Syzran Military Hospital

In 2011 Central Military Hospital Syzran Military District--the former 417-th Syzransky garrison military hospital Russian Defense Ministry--celebrated the 65th anniversary. At different periods in the hospital were deployed 50, 100 and 150 beds in 3, 4 and 6 units, respectively. Currently Syzran Military Hospital, part of the Federal State Institution "354 District Military Clinical Hospital", the Russian Defense Ministry-- a multi-facility consisting of 6 diagnostic and treatment departments and offices.     

解放军总医院药房信息系统应用

目的探讨解放军总医院药房信息系统应用现状,推动药房信息系统的改革和发展。方法分析解放军总医院药房信息系统的应用现状,总结当前信息系统的不足和经验。结果运用先进的信息系统提高了药房的工作效率,降低了人为差错的发生率,大大改善了传统药房简单的药品供应模式,极大的促进药师参与临床合理用药,但许多信息系统缺陷需要改进。结论药房应用先进信息系统,增强药师指导合理用药的作用,药房工作效率提高,医院效益提高,但由于医院经济条件、人力资源以及后期软件维护费用高等原因,信息系统仍有许多不足。     

Hospital infections in radiology clinics

Hospital infections are serious concerns for health care workers and patients. Needle stick injuries, blood contacts, airborne infections and any kind of contamination pose a risk for hospital infections. The risk of hospital infection has been increased in radiology since the number of the patients and the exposure time between patients and radiology workers have increased especially with the usage of new modalities in the last three decades. Hospital infection risk and some universal standards and policies for protection were summarized in this article.     

Vaccination against hepatitis B in the Sarajevo Military Hospital]

The intermediate prevalence of HBV infection (28.6%) was found in the staff of the Sarajevo Military Hospital without any significant difference related to the profession of the examinees. The vaccination against hepatitis B was accepted by 23 (18.3%) of 126 candidates and it was performed with 3 doses of "ENGERIX-B" vaccine. The protective levels of anti-HBs antibodies (10 IG/1) were found in 21 (91.3%) vaccinated persons a month after the third dose had been given. It was concluded that the vaccination is justified in collectives with the registered intermediate prevalence of HBV infection. In collectives with high prevalence, the vaccination is recommended only for newly employed workers.     

Drug abuse treatment at the San Martin General Hospital, Buenos Aires

The General Hospital facilitates the detection of users and abusers who seek care for other diseases. The research programme on drug abuse is operated at the Mental Health Department of the Hospital General San Martin, Medical School, Buenos Aires University. Characteristics of the population attended are described according to the age, sex, drugs of abuse, gateway drugs, places and ages, and other psychiatric diagnoses according to the DSM III. Finally, therapeutic resources are described: individual and family psychotherapies and family counselling.     

Cardiac magnetic resonance imaging: the Massachusetts General Hospital experience

The combination of gated cardiac imaging with the magnetic resonance parameters of flow void and tissue characterization forms the basis for a powerful noninvasive technique for imaging the cardiovascular system. Images constructed in planes orthogonal to the axis of the heart allow cardiac structures to be reproducibly detected in serial studies and measured. The data acquisition techniques used at Massachusetts General Hospital are presented, along with examples of their application in a variety of cardiac diseases. Future prospects are illustrated with flow-encoded images and with surface coil techniques.     

A retrospective analysis of open fractures sustained by U.S. military personnel during Operation Just Cause.

A retrospective analysis was conducted of 37 open fracture cases sustained by U.S. military personnel during the recent low-intensity conflict in Panama (Operation Just Cause). The etiology, location, classification, and management of open fractures sustained in combat is presented. A significant difference was noted in the infection rate for type III open fractures that were debrided in Panama (22%) as compared to those that were debrided only after transport to CONUS (66%). This study supports the critical importance of adequate battlefield surgical support in low-intensity conflicts, and reemphasizes the crucial role of early surgical debridement for the prevention of wound infection.     

Describing the life cycle of U.S. Marine Hospital #17, Port Townsend, Washington, 1855-1933

This study was undertaken to determine why U.S. Marine Hospital #17, Port Townsend, Washington, closed at the peak of its utilization. A social history approach was taken, examining the hospital's developmental changes in the context of its role in the larger society. Both firsthand and interpretive sources were reviewed, and numerous photographs and drawings confirmed the hospital was an active participant in the economy. Regarding the hospital's transitions over time as a life cycle was a useful organizing framework. Inpatient census patterns as a measure of the hospital's growth and development informed and enlightened this study. It became clear the Marine Hospital responded to and influenced events in the Port Townsend seaport whose importance diminished when other port cities at the base of the Puget Sound began and sustained rapid growth.     

Distant pulse-wave lithotripsy in the Central Clinical Air Force Hospital

With participation of the specialists from the 7th Central Military Clinical Aviation Hospital 4 pulse-wave complexes "Urat-P", "Urat-P2", "Ulitho", "Cholelithotriptor" were developed and introduced into clinical practice of the hospital. Distant pulse-wave lithotripsy was conducted 3035 patients (358 persons from flying staff). It is the main method of urolithiasis treatment, especially in the flying staff. Its efficiency is more than 96%. The modern models of lithotriptors are effective in destruction of biliary and urinary calculi and the applied parameters of wave impulses don't impact on the organs and tissues. The sphere of use of pulse-wave effect in the clinical practice was extended.     

Post-invasion change in the trend of complications and outcome of pregnancy in Maternity Hospital Kuwait from 1981 to 1995.

To assess the trend in the complications and outcome of pregnancy in Maternity Hospital, Kuwait, a retrospective analysis of yearly hospital statistics books and labour ward records of patients delivering in Maternity Hospital Kuwait was carried out for the period 1981 to 1995. In the post-invasion period there is a significant rise in: primiparity; mothers aged 35 years or older; Kuwaiti mothers; and in multiple pregnancy. The incidence of pregnancy-induced hypertension, pre-eclampsia, and hysterectomy for postpartum haemorrhage also increased. There was a significant increase in spontaneous abortions and low birth weight babies. The incidence of hydatidiform mole has significantly decreased. Still birth rate shows a decreasing trend in the study period. The significant change in the age and parity of the mothers delivering in the post-invasion period might partly explain the above changes. However, the effect of environmental pollution, social and psychological stress, and anxiety due to war may have also contributed to an increase in the complications and adverse outcomes of pregnancy.     

Hospital Outpatient Prospective Payment System

A brief review of the Hospital Outpatient Prospective Payment System (HOPPS) is presented highlighting the program's legislative history, outpatient service classifications and payment plan. Specifically, HOPPS measures applicable to imaging practices are discussed. Resources are also provided for further information on the program requirements and the ambulatory payment classifications (APC) system.     

Certification of deaths at Umtata General Hospital, South Africa

BACKGROUND: Audited information on the causes of death is one of the basic components of a country's health information system. Data are usually derived from death certificates. There are many shortcomings in the routine collection of such information. A critical analysis of Umtata General Hospital's (UGH) death certification was done establish how these shortcomings might influence reporting. Such an audit is simple, cheap and useful for monitoring the quality of mortality information. It can be used in health planning and management. OBJECTIVES: To determine the accuracy of death certification by doctors in Umtata General Hospital. METHOD: The study was carried out at UGH. Three hundred and four (304) death notification forms collected over a period of 1 year from January 1999 to December 1999 were studied. These forms were obtained from different clinical departments. RESULTS: The majority of deaths (78.9%) were certified as cardiorespiratory failure. In the remaining (21.1%) cases the causes of death were stated as due to esophageal carcinoma, lobar pneumonia, severe shock, diarrhea, and unknown. CONCLUSION: Doctors at Umtata General Hospital are not experienced in death certification. Cardiorespiratory failure is neither a cause of death nor a mechanism of death. RECOMMENDATIONS: There is need for continuing education on death certification by doctors at UGH.     

天坛医院发热门诊患者临床特征分析

 目的 调查北京天坛医院发热患者的就诊情况,为发热门诊合理诊疗提供参考依据。方法 以北京天坛医院2017年1—2月发热门诊的1288例就诊患者为研究对象,采用登记汇总统计分析的调查方式。分别对就诊患者的性别、年龄、发热程度、发热时间、病因等进行统计分析。结果 发热门诊患者男性多于女性;发热程度以中等程度发热为主,占发热总数的78.8%,中等发热组与其他发热组相比,差异有统计学意义(P<0.01);病因主要为呼吸系统感染,占病因总数的67.2%,急性呼吸系统感染组与其他病因组相比,差异有统计学意义(P<0.01);年龄主要分布于50～60岁,占发热的36.6%,50～60岁组与其他年龄组相比,差异有统计学意义(P<0.05);就诊时间以间隔12～24 h者为主,占46.8%,12～24 h组与其他就诊时间组相比,差异有统计学意义(P<0.05)。结论 发热门诊在发热患者诊疗过程中发挥着重要的作用,发热患者的患病特点呈一定分布规律。     

Hospital Outpatient Quality Data Reporting Program

A brief review of the Hospital Outpatient Quality Data Reporting Program (HOP QDRP) is presented highlighting the program's legislative history, outpatient imaging efficiency measures and program requirements. Specifically, HOP QDRP measures applicable to imaging practices are discussed. Resources are also provided for further information on the program's requirements and measures.     

Update of radiosurgery at the Royal Adelaide Hospital

This is an update of the Royal Adelaide Hospital radiosurgery experience between November 1993 and December 2004 comprising 165 patients with 168 intracranial lesions. Including re-treatment, there were 175 treatment episodes (163 radiosurgery and 12 stereotactic radiotherapy) at an average of 1.3 per month. The commonest lesions were acoustic neuroma (65), arteriovenous malformation (58), solitary brain metastasis (23) and meningioma (14). The clinical features, treatment details and outcome are described. Our results continue to be well within the range reported in the published work. Radiosurgery provides an elegant, non-invasive alternative to neurosurgery and conventional external beam radiotherapy for many benign and malignant brain tumours.     

Demographics, stone characteristic, and treatment of urinary calculi at the 47th Combat Support Hospital during the first 6 months of Operation Iraqi Freedom

There are few publications describing urolithiasis in deployed military personnel. Renal colic was the most common urologic indication for air evacuation from the 47th Combat Support Hospital during the first 6 months of Operation Iraqi Freedom and we describe our observations and experience herein. Institutional review board approval was obtained to create a database of patients presenting to the 47th Combat Support Hospital with urolithiasis. Patient demographics, stone characteristic, imaging modality, urinalysis results, treatment course, and outcomes were evaluated for 182 patients. Sixty percent of patients qualified for conservative treatment and spontaneous stone passage was documented in 28%. We conclude that conservative therapy is safe and appropriate initial treatment for the majority of deployed personnel with urinary calculi, however, many patients were lost to follow-up. No patient treated conservatively required admission for sepsis, azotemia, or other serious stone-related complication.