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Biomedical subjects

R J Lloyd

Publications and source records attributed to R J Lloyd.

8 recordsLinked to original sources

Transvenous closure of patent ductus arteriosus in a sick 2780g infant.

A three-and-a-half-month-old 2780 g critically ill infant had successful transvenous coil occlusion of a ductus arteriosus. At six-and-a-half months of age the infant died, and autopsy showed coverage of the coil on the aortic aspect and no lumenal narrowing. It was concluded that transvenous coil occlusion of the patent ductus arteriosus in small infants is possible and that th venous route is preferred to be arterial route.

Amniocentesis↗

Effective ED complaint management.

Handling patient complaints is possibly one of the most delicate tasks any manager must face. Although managing patient complaints is never a pleasant experience, a detailed plan can make it easier and more uniform, resulting in less stress and anxiety. Before improvements can be accomplished, deficiencies in the system must be corrected. Only after the department's processes have been deemned stable can the qualiuty of care be improved and the customer satisfied.

Documentation↗

Managing negative outcome by reducing variances in the emergency department.

Negative outcome management depends upon reducing variances in the structure and process of health care. In the multitask environment of a hospital's emergency department (ED), a system is required to monitor the many tasks for variances. Without a monitoring system in place, the cumulative effect of these structure and process variances will significantly contribute to negative outcomes. Structure and process variance management requires a customer-focused, process-conceptualization approach that attempts to manage the many small variances in care along the entire chain of interdependent processes making up the ED system. Process mapping is one technique that enables management to understand and anticipate variances and take corrective action to eliminate them before they occur.

Cost-Benefit Analysis↗

Case report 610: Amyloid arthropathy of the left ankle.

In summary, a case of amyloid arthropathy of the left ankle in a 64-year-old patient with multiple myeloma is presented. The asymmetric presentation and site of deposition in the ankle were taken to be unusual. Involvement of both hips and the right shoulder was also suspected on subsequent evaluation. The patient's history and MR studies were essential in establishing the preoperative diagnosis. The extent of involvement, destruction of underlying cartilage, associated effusion and tenosynovitis were optimally defined by the MR images. The MR images also provided preoperative guidance in determining the approach and optimum site of biopsy.

Amyloidosis↗

Tumoral calcinosis in multiple digits: a case report.

Tumoral calcinosis usually appears in the vicinity of large joints, and its appearance in the fingers must be quite rare since no reports of such an occurrence have been found. A case report of the presence of tumoral masses of hydroxyapatite in multiple digits is presented. No causative or related metabolic or collagen-vascular disease was identified, and the patient remains in good health.

Calcinosis↗

Four-way, multicenter, crossover trial of ibuprofen, fenoprofen calcium, naproxen, and tolmetin sodium in osteoarthritis: comparative clinical profiles.

One hundred forty-one subjects with osteoarthritis completed this double-blind, multicenter, crossover trial comparing four nonsteroidal anti-inflammatory (NSAI) agents after single-blind aspirin stabilization. Preferences of both patients and physicians showed the following rank order from most to least preferable: tolmetin sodium, naproxen, ibuprofen, fenoprofen calcium. By all but three of more than 20 measures of efficacy, tolmetin sodium and naproxen were the more effective pair and fenoprofen calcium and ibuprofen the less effective pair of the four. Eight of nine measures of tolerability suggested the following rank order from best to worst tolerated: ibuprofen, naproxen, tolmetin sodium, fenoprofen calcium, aspirin. Few differences among the newer NSAI agents compared in this study achieved statistical significance. Nevertheless, the tolerability-efficacy relationships that emerge from studies of this type can help to define rational approaches to the use of these drugs in rheumatic diseases.

Adult↗

Developing EMS quality assessment indicators.

An emergency medical service (EMS) system is part of a broad health care system which no longer can be concerned exclusively with patient transportation. Integration of prehospital and in-hospital emergency care must be achieved to provide quality patient care. This article suggests modifications in the Joint Commission on Accreditation of Healthcare Organization's (JCAHO) 10-Step Model indicators that should help in an evaluation of the issues associated with the diversion of patients from Emergency Departments. The JCAHO model is one that can be used to help integrate prehospital and inhospital care.

Emergency Medical Services↗