Primary carcinoma of the appendix

Primary adenocarcinoma of the appendix is a rare tumor. Fewer than 200 cases are on record. Correct preoperative diagnosis is virtually nonexistent. Two patients with adenocarcinoma of the appendix are described. Although appendectomy appears to be adequate treatment for carcinoid, right hemicolectomy is, in our opinion, the treatment of choice for mucinous cystadenocarcinoma, while it is mandatory in cases of adenocarcinoma of the colonic type.     

Tokolysis using Berotec aerosol

It has been tested whehter the uterine motor activity could be suppressed by inhalation of Berotec--aerosol. Fast developing, effective but short-lived tocolytic effect was demonstrated. The treatment could be carried out easily and proved to be efficient by briefly quiescing the uterus in obstetrical emergencies or starting longterm tocolysis, as started by the authors.     

Weather front sensitivity as an influencing factor in the onset of labor

The connection between meteorological stimuli and the onset of labor was examined on the basis of the patients' front-sensitivity. Front-sensitivity was tested by a questionary containing 60 questions. Converse relation was observed between the degree of sensitivity and the gestational age. A sudden rise of onsets of labors could be shown during frontal changes, occurred after meteorologically quiet periods. During frontal changes the ratio of onsets of labors rose significantly among those patients who were sensitive tho the given front. This effect could be observed during a longer period of frontal influence. By the authors opinion also meteorological stimuli can be regarded as one of the factors, determining the actual date of onset of labor among front-sensitive women.     

Fatal outcome of Kawasaki syndrome in a 4-week-old infant

A male infant at 4 weeks of age with features of Kawasaki disease is described who died at the end of the second week of his illness in consequence of serious pneumonia. The diagnosis was confirmed by laboratory tests and post mortem histological examinations. The latter showed systemic vasculitis without any changes of coronary arteries.     

Plan-do-study-act cycles as an instrument for improvement of compliance with infection control measures in care of patients after cardiothoracic surgery

The aim of this study was to determine whether compliance with infection control measures for the care of patients during and after cardiothoracic surgery could be improved by using 'plan-do-study-act' (PDSA) improvement cycles in a 715-bed university hospital. The endpoints of these cycles were indices of correct procedure based on infection control standards. The intervention consisted of instruction and training of nursing and medical staff on the use of PDSA cycles, feedback of the baseline measurements, and the use of posters in the proximity of the operating room (OR). At follow-up, overall compliance only improved in the room used by the perfusionists and the OR. After the follow-up period, monitoring revealed a drop in compliance in the OR, but improved compliance during vascular catheter care of patients with prolonged stay in the intensive care unit (ICU), and during wound care of patients on the nursing ward. The last series of monitoring showed that compliance with general infection control measures in the OR had improved again, and that compliance had remained satisfactory on the ward and in the ICU, with the exception of patients recently transferred to the ICU from the OR. The results show that by using PDSA cycles, compliance with infection control measures can improve significantly. However, repeated monitoring is necessary to ensure continued compliance.