The issues regarding screening and identification of patients at risk for human immunodeficiency virus (HIV) infection before surgery continue to be discussed, and there is a need for information regarding attitudes of both surgeons and patients to this issue. A population of HIV-positive patients attending a genitourinary medicine clinic were given an anonymous questionnaire to review their experiences of attending for operation. Of 174 patients who replied, 52 had undergone a total of 65 procedures. In all but three of the operations, the HIV status was made known to the surgeon.

Adult↗

PubMed1992

Seminoma or sarcoid?

A 33-year-old man subsequently diagnosed as having sarcoidosis presented with the clinical features of a testicular tumour with metastatic spread to para-aortic lymph nodes. Histological examination of the testis and para-aortic lymph node biopsy showed florid granulomatous change and a Kveim test was positive. This is a previously unreported presentation of sarcoidosis and emphasizes that histological confirmation of malignancy is essential prior to institution of cytotoxic therapy.

Adult↗

PubMed1992

Clinical information system that enhances the use of resources in endoscopic prostatic procedures.

In this study we evaluated, by means of an automated management system, the identification of subgroups of patients within certain operative categories whose predictable length of stay was compatible with treatment on a 5-day ward. This was achieved by using a computer directed analysis of urological workload on prospectively collected clinical data. Graphical presentation of the results was achieved by a technique known as the patient-bed dissociation curve. Patients with bladder outflow obstruction treated by transurethral prostatic resection (701) and bladder neck incision (113) were selected from a total of 7,162 hospital admissions. The main outcome measures were length of stay and complication rates for the 2 procedures. The results demonstrated that a group of patients about to undergo transurethral resection could be selected by age and source which would indicate an 18% greater probability of discharge within 5 days. These patients were easily identifiable in advance and would be suitable for treatment on a 5-day ward. It was concluded that computer-held clinical data were easily accessible to the surgeon. The process of detailed analysis need not take time. With properly directed studies the information retrieved could be used to effect change. The patient-bed dissociation curve may prove a valuable tool in examining and comparing discharge patterns in any groups of patients.

Adult↗

PubMed1992

Combined surgical audit by microcomputer involving units in four health regions.

Explore the source record for details and available documents.

England↗

PubMed1991

Comparative audit: a new method of delivering audit.

A new method of audit delivery is described, based on the first large scale comparative audit meeting held at The Royal College of Surgeons of England. The concept of comparative audit is introduced and the methods of undertaking such an exercise are described. This comparative audit processed the clinical activity of 45 general surgeons during 1989 amounting to 49,005 patient admissions. As an illustration of this technique the comparative analysis of 3,710 inguinal hernia procedures accounting for 12,600 total stay days is used in order to illustrate data manipulation, ranking and presentation in chart form. Conclusions are drawn and suggestions as to the future role of the technique are outlined.

Data Interpretation, Statistical↗