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Biomedical subjects

J C Hyde

Publications and source records attributed to J C Hyde.

15 recordsLinked to original sources
PubMed1999

Cushing's syndrome caused by nodular adrenal hyperplasia in children with McCune-Albright syndrome.

McCune-Albright syndrome consists of fibrous dysplasia of bone, café-au-lait skin pigmentation, and endocrine dysfunction (usually precocious puberty). Other endocrine abnormalities occur in a minority of patients, and of these, Cushing's syndrome is the least often recognized. We present 5 children (4 girls) with features of McCune-Albright syndrome who had Cushing's syndrome in the infantile period (<6 months). In 2 children spontaneous resolution occurred, but the remaining 3 required bilateral adrenalectomy. In addition, all 4 girls have experienced precocious puberty, and 3 children demonstrated radiologic evidence of nephrocalcinosis. Understanding of the underlying defect causing McCune-Albright syndrome emphasizes the importance of searching for other endocrine dysfunction in these children.

Adolescent↗
PubMed1998

Theoretical foundations of TQM and CQI: or, does quality really have its own theory?

Total quality management and continuous quality improvement have been advocated as management salvation and anecdotally have been linked to improvements in operational effectiveness. The Joint Commission on Accreditation of Healthcare Organizations has adopted quality management as the organization improvement measure of the future and has mandated its application. The article explores the theoretical foundations of quality management and presents an integrated model dealing with this industry standard. An operational framework for managers is provided in an attempt to demystify the quality jargon that is so prevalent. The article also provides a prescriptive management overview incorporating quality management techniques into everyday operations.

Feedback↗
PubMed1994

Determinants of physician vacancy rates in rural hospitals.

This study examines the determinants of physician vacancy rates in rural hospitals from the perspective of the rural hospital administrator. Data on community characteristics, hospital characteristics, and hospital recruitment strategies are examined for 50 rural hospitals in Kentucky using questionnaire and archival data. Physician vacancy rates in this sample were quite high (mean of 37 percent). Results indicate lower physician vacancy rates in hospitals with a chain affiliation. In addition, the "job shopping" model for physicians decisions on where to practice (Johnson, 1978) is supported. Hospitals that target physician candidates with more work experience display lower physician vacancy rates. Generally, hospital characteristics were more significant predictors of physician vacancy rates than were community characteristics. Implications for rural hospital physician recruitment/retention strategies are discussed.

Career Choice↗
PubMed1984

Neonatal hyperparathyroidism.

We describe a girl with congenital hyperparathyroidism who presented soon after birth with respiratory distress, hypotonia, feeding difficulties, and bone deformities. Hypercalcaemia, hypophosphataemia, and raised alkaline phosphatase were present and plasma parathyroid hormone levels measured by radioassay and bioassay were raised. X-rays showed gross demineralisation with metaphyseal fractures, erosions, and sub-periostal reaction along the bones. Following surgical removal of four hyperplastic parathyroid glands and subsequent maintainance therapy with 1-alpha-hydroxycholecalciferol there has been virtually complete reversal of her bone abnormalities.

Female↗
PubMed1976

Electron cytochemical localization of gamma-aminobutyric acid catabolism in rat cerebellar cortex.

An electron cytochemical technique is described for the localization of GABA-T, the enzyme which degrades the neurotransmitter GABA, in rat cerebellar cortex. The technique allows ultrastructural demonstration of GABA-T activity by the final deposition of an electron dense formazan precipitate at reaction sites, whilst maintaining adequate ultrastructural preservation for recognition of cellular and subcellular structures. Numerous electron dense precipitates are evident as discrete punctate deposits situated mainly in mitochondria of stellate cells, basket cells and astrocytic glial cells; they are also seen in axonal or dendritic profiles at some synaptic junctions. The technique enables the first cytochemical demonstration of the mitochondrial localization of GABA-T activity in nervous tissue to be presented. It establishes that GABA-T is present in supposed GABA neurones, in pre- or post-synaptic endings, or both, of presumed inhibitory synapses and in glial cells which may be associated with these synapses. From this seemingly ubiquitous distribution, functional aspects of GABA-T in these cells is considered.

4-Aminobutyrate Transaminase↗
PubMed1976

Improved histological localization of GABA-transaminase activity in rat cerebellar cortex after aldehyde fixation.

A method for the chemical fixation of the enzyme GABA-transaminase in nervous tissue is described. It is shown that after perfusion with a formaldehyde/glutaraldehyde fixative, activity of the enzyme in cerebellar cortex is demonstrable whilst cellular morphology is preserved. Results from the improved technique have shown new sites of GABA-transaminase activity in cerebellar cortex. In view of these results a special function for glial cells in this area of brain has been suggested.

4-Aminobutyrate Transaminase↗
PubMedDate not supplied

Getting off the bandwagon: an academic health center takes a different strategic path.

Focusing on one state university academic health center (AHC) located in a rural setting in the southeastern United States, this case study investigates the strategic response to the increasingly turbulent and competitive environment in the healthcare industry. The qualitative research reported here involved a review of pertinent documents and archival data and interviews with key informants including AHC executives and staff, community leaders, and others. Additional information was obtained from published sources, including a literature review that covers a five-year period ending in 1997 and searches conducted using the key words "academic medical or health center." The AHC in this case study demonstrates how it is possible to respond proactively to changes in the environment without sacrificing the multiple missions of the institution. This AHC implemented strategies that ensure access for both inner city and rural underserved populations while providing venues for primary care training and educational programs. In addition, the AHC positioned itself to compete more effectively by implementing a continuous quality improvement program that is aimed at maximizing quality while controlling costs. Administrators in not only AHCs but also other healthcare organizations, such as community hospitals and competing systems, should consider the findings from this case study useful in evaluating existing strategies and possible alternatives. In particular, the use of an affiliation strategy for growth in a resource-poor environment may encourage organizations located in rural areas to consider innovative expansion strategies to develop integrated systems of care.

Academic Medical Centers↗