Antimicrobial sensitivities in urinary tract infections in men

Six-thousand-seven-hunderd and forty-nine positive urine cultures from a large metropolitan Veterans Administration hospital were analyzed with respect to the organisms isolated and their antimicrobial sensitivies. A predicted therapeutic efficacy index was calculated for each antimicrobial agent tested. Gram-negative pathogens accounted for 84% of the infections. Proteus infections outnumbered those due to strains ofEscherichia coli. Gentamycin was found to be the most effective antimicrobial agent.     

Utility of an on-line computer system in a clinical setting for nutrient intake analyses

The present report describes a four-week trial at the Victoria General Hospital, Halifax, to determine the effect of access to a computer system on nutrient intake analyses, the problems in implementation of the system, and the response of the staff dietitians. An on-line system was obtained from the Ohio State University Hospitals and modified to reflect Canadian food and nutrient content, and to include some additional program features. Twelve hundred and eighty-six foods were characterized according to 15 food components, the system was responsive to nine interactive commands, and there were nine possible print-out formats of calculations. The results of the trial reinforced the expectation of greatly increased work efficiency, however, the system was not utilized to its potential. Some technical problems were largely overcome within the first week of operation. However, needs relating to the extensiveness of the food and nutrient data base, and the methodologies and time for obtaining and evaluating individual dietary intake information prevented maximum efficiency. The dietitians liked the comprehensiveness and detail of the system, however, routine dietary intake collections were too time-consuming for their present work schedules.     

Pediatric emergency information sheet using a microcomputer

Calculating the appropriate dosage of a drug and the right equipment size during an emergency situation can be a time-consuming, frustrating, and error-prone process, considering the shortage of time during a resuscitation. A microcomputer program was developed to aid in the care of pediatric patients in emergency or 'code' situations. This is accomplished by use of a printout of a patient-specific chart for most needed critical care drugs and equipment used during an emergency. This program is written in "C" language and is menu-driven.     

Birth registry

Birth registries are among the most common type of registry found in hospitals. Brigham and Women's Hospital has a high number of births annually. The following represents a brief overview of the status of this type of registry in healthcare today.     

Hürthle cell (oxyphilic) papillary thyroid carcinoma: a variant with more aggressive biologic behavior.

The latest World Health Organization International Classification defines papillary thyroid carcinoma by its "follicular cell differentiation...as well as characteristic nuclear changes". However the oxyphilic (Hürthle cell) papillary carcinoma have nuclei which generally resemble the nuclei seen in oxyphilic follicular carcinomas, and such oxyphilic papillary tumors may behave more aggressively than typical papillary cancers. To further characterize these rare tumors, we identified during a 32-year period 22 patients with oxyphilic papillary cancer and compared them with 1,084 patients with typical papillary cancers and 57 patients with oxyphilic follicular cancers treated by the Mayo surgical group during the same time period. Although typical papillary and oxyphilic papillary cancers were comparable with regards to patient age, tumor size and extent, TNM stage, and prognostic score (AGES), there were significant differences. Compared to typical papillary tumors, oxyphilic papillary cancers had fewer neck nodal metastases at primary diagnosis (5% vs 40%, p less than 0.0001), were more often DNA non-diploid (71% vs 21%, p less than 0.001), and after 10 postoperative years had higher rates of both tumor recurrence (28% vs 11%, p less than 0.0001) and cause-specific mortality (1.7% vs 4%, p less than 0.0005). In these four important respects the oxyphilic papillary cancers more resembled the oxyphilic follicular cancers. For oxyphilic follicular cancers, the frequency of initial neck nodal metastases was 7% (cf 5%); 83% of the oxyphilic follicular tumors were non-diploid (cf 71%), and at 10 years postoperatively the tumor recurrence and cause-specific mortality rates were 28% and 18%, insignificantly different from 28% and 17% seen with the oxyphilic papillary cancers.(ABSTRACT TRUNCATED AT 250 WORDS)     

Data and decisions: can mental health management be knowledge-based?

Three major factors suggest a healthy future for data-based decision making within mental health authorities: (1) the improved knowledge base related to the treatment and management of serious mental illness, (2) advances in data-processing technology and (3) conceptual advances in management information system design, most notably the National Institute of Mental Health (NIMH) Mental Health Statistics Improvement Package. This paper briefly outlines these three factors and goes on to examine information needed by state mental health authorities (SMHAs) to enhance decision making. The client-level data necessary for data-based policy decisions, while still scarce, are increasingly available and are increasingly finding homes within SMHA management information systems. As SMHAs improve their information systems to accommodate such data, they face substantial implementation challenges and substantial payoffs in terms of increased knowledge for decision making.