RESUMEN
Surgical treatment of spine and spinal cord diseases is one of important objectives in modern neurosurgery. Patient safety is a priority in spine and spinal cord surgery. Intraoperative imaging ensures efficacy and safe surgery with and without stabilization, preoperative marking, control of decompression and correct implant placement. Surgical C-arms and intraoperative cone-beam CT scanners are the most widespread in everyday practice. The latest achievement was intraoperative spiral computed tomography. C-arms and CT scanners with intraoperative navigation increase the efficiency and safety of surgical interventions.
Asunto(s)
Enfermedades de la Médula Espinal , Enfermedades de la Columna Vertebral , Cirugía Asistida por Computador , Tomografía Computarizada de Haz Cónico , Humanos , Procedimientos Neuroquirúrgicos , Enfermedades de la Médula Espinal/diagnóstico por imagen , Enfermedades de la Médula Espinal/cirugía , Enfermedades de la Columna Vertebral/diagnóstico por imagen , Enfermedades de la Columna Vertebral/cirugía , Columna Vertebral , Tomografía Computarizada por Rayos XRESUMEN
Each year 1 in 160 people in the United States suffers from acute myocardial infarction (AMI). Of these more than 1.5 million cases annually, 500,000 end in fatalities. This study's purpose was to describe and evaluate the role hospital characteristics play in rates of mortality caused by AMI in acute-care California hospitals. Characteristics evaluated include structural characteristics--i.e., teaching status, percentage of board-certified physicians, registered nurse hours per patient day (RN hours/patient day), volume of cases, technological resource availability, and urban density; and financial characteristics--profit status and total operating expenses per patient day. Although part of a larger investigation correlating mortality and length of stay, this article reports only the results for significant influences on mortality.
Asunto(s)
Economía Hospitalaria , Administración Hospitalaria , Hospitales/estadística & datos numéricos , Infarto del Miocardio/mortalidad , Calidad de la Atención de Salud , California/epidemiología , Humanos , Modelos LinealesRESUMEN
Death, although not the only measure of adverse outcome, has been studied more than any other single occurrence. The authors discuss the findings of these studies and propose a conceptual framework to explain the relation between several hospital characteristics (e.g., profit status, RN ratios) and inpatient mortality rates. These studies raise the issue of whether some hospital characteristics are distal contributors and others, such as RN ratios, are more proximal explanatory variables of the mortality rate. Implications for understanding the relation of nursing's role in the array of potential contributors are discussed.
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Administración Hospitalaria , Mortalidad Hospitalaria , Certificación , Economía Hospitalaria , Hospitales de Enseñanza/organización & administración , Hospitales de Enseñanza/estadística & datos numéricos , Humanos , Pacientes Internos/estadística & datos numéricos , Cuerpo Médico de Hospitales/organización & administración , Cuerpo Médico de Hospitales/provisión & distribución , Personal de Enfermería en Hospital/organización & administración , Personal de Enfermería en Hospital/provisión & distribución , Propiedad , Carga de TrabajoRESUMEN
This ex post facto correlational study reports the influence of eight hospital structural and financial characteristics on mortality and length of stay (LOS) in acute myocardial infarction patients in 373 California hospitals. Significant results include: registered nurse hours/patient day (RN hours/pt. day) were inversely related to mortality in bivariate and regression analyses and to LOS in regression analyses. Total operating expenses/patient day (TOE/pt. day) were positively related to mortality (regression analyses) and LOS (bivariate analysis). The authors discuss implications for research and administration.
Asunto(s)
Economía de la Enfermería , Administración Financiera de Hospitales/economía , Costos de Hospital/estadística & datos numéricos , Mortalidad Hospitalaria , Tiempo de Internación/economía , Infarto del Miocardio/economía , Infarto del Miocardio/mortalidad , California , Humanos , Investigación en Administración de Enfermería , Análisis de Regresión , Carga de TrabajoRESUMEN
This investigation compared magnetic resonance imaging (MRI) with computed tomography (CT) in the evaluation of normal and abnormal adrenal glands. Thirty normal volunteers were studied with MRI, and the results were compared with a retrospective review of 30 normal CT examinations. CT identified both adrenal glands in all 30 patients. MRI identified both glands in 29 of 30 volunteers. There were no statistically significant differences between the two imaging techniques using chi-square analysis. Twenty-one patients with abnormal adrenal gland(s) detected with CT were also studied with MRI. The abnormalities studied included bilateral hyperplasia (three patients), adenoma (two), myelolipoma (one), adrenal metastases (six), adrenal hemorrhage (two), and neuroblastoma (seven). MRI detected the abnormal adrenal gland(s) in 20 of 21 patients. MRI was unable to detect calcifications in the lesions studied but more clearly showed the relations of adrenal masses to the major vascular structures. MRI demonstrated corticomedullary differentiation in patients with adrenal hyperplasia and in some normal volunteers. The CT and MRI features of the adrenal lesions are discussed.