A 39-year old male patient with a history of four episodes of meningitis (two of them due to Neisseria meningitidis) since the age of 12 developed meningitis caused by an ungroupable streptococcus. Deficiency of the sixth component of complement was discovered, making this the ninth case of recurrent meningitis associated with C6 deficiency. Streptococcal meningitis had never been reported in such cases.

Adult↗

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The diffusion of an evidence-based disease guidance system for managing stroke.

This paper describes the diffusion of an evidence-based stroke guidance system (SGS) in a field setting through participatory research. SGS enables physicians to review relevant evidence-based literature, from which patient orders are generated for managing cerebrovascular accident. The paper focuses on the question 'what are the barriers and enablers to adopting SOS?' The research site consisted of eight hospitals within two health regions in Alberta, with 47 physicians as the intended users. The data sources consisted of surveys, education sessions, design feedback, field observations, and usage logs. Preliminary results revealed an initial slow rate of adoption that gradually improved with the influence of clinical champions, more effective communication, sustained education, round-the-clock support and continued system refinement. These initial findings suggest that models of technological diffusion can help us better understand the complexities of changing physician practice behaviors.

Attitude to Computers↗

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Cervical artery dissections in the puerperium: pathogenic hypotheses concerning seven observations.

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Cerebrovascular Disorders↗

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[Hyponatremia and probable inappropriate secretion of antidiuretic hormone due to citalopram].

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Aged↗

PubMedDate not supplied

A tale of two nursing centers: a cautionary study of profitability.

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Ambulatory Care↗

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Association of macrophagic myofasciitis and fibromuscular dysplasia with renal fibromuscular dysplasia: first case report.

Two rare muscular diseases, macrophagic myofasciitis and fibromuscular dysplasia, are associated in the patient reported here. Their respective etiologies are unknown. The possible link has to be discussed.

Angiography↗

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Survival of nurse-managed centers: the importance of cost analysis.

Despite the explosive growth in nurse-managed centers (NMC) in the past 20 years, most have been unable to achieve financial self-sufficiency, and many have closed. Combining costing techniques with outcome measures provides essential information needed by NMC for making operating decisions and for marketing NMC performance. These outcome data can be persuasive to policy makers and institutional decision makers and are crucial for NMC to improve their competitiveness in the health care market place.

Birthing Centers↗

PubMedDate not supplied