Saint Francis Medical Center Research Articles

Real-time telementoring in ophthalmology.

To determine if current telemedicine technology can support real-time telementoring to teach ophthalmologic surgical procedures in remote areas. Using an integrated systems digital network (ISDN) line conveying information at a rate of 128 kbps, an endoscopic laser-assisted dacryocystorhinostomy (ELA-DCR) procedure was transmitted in real time from the Saint Francis Medical Center in Honolulu, Hawaii, to ophthalmologists at the Makati Medical Center in Manila, Philippines, more than 5000 miles away. Live surgical and endoscopic images were sent real time with explanations by the surgeon and with interactive questions and answers during and after the procedure. The ELA-DCR procedure was transmitted in real time from Honolulu to more than 100 ophthalmologists at the Makati Medical Center in the Philippines. Current technology in telemedicine can support the use of real-time surgical telementoring to teach complex ophthalmologic procedures.

Poster 115 An atypical presentation of syringomyelia: A case report: Angela L. Guccione, MD (Saint Francis Medical Center, Pittsburgh, PA); Mary Ann Miknevich, MD; Mary E. Langer-Schnepp, PTC

Poster 115 An atypical presentation of syringomyelia: A case report: Angela L. Guccione, MD (Saint Francis Medical Center, Pittsburgh, PA); Mary Ann Miknevich, MD; Mary E. Langer-Schnepp, PTC

A comparison of outcome focused documentation with soap notes for inpatient care at Saint Francis Medical Center, Peoria, IL

Outcome Focused Documentation (OFD) was initiated eight months ago at Saint Francis Medical Center, a teaching hospital, to improve documentation focus on nutrition concerns and to increase physician response to dietitian recommendations. OFD incorporates a problem list format and charting by exception. Nutrition problems and concerns are clearly identified and focus on an action plan of treatment and patient outcome results through specific nutrition care interventions and recommendations. Following extensive staff training, implementation of OFD and ongoing medical record audits, a survey of inpatient dietitians was conducted. The survey found that 100% of the dietitians agreed that OFD clearly identifies nutrition problems and focuses on outcome results and actions better than SOAP format. To assess physician receptiveness to dietitian recommendations, medical records were reviewed to check for a physician order within 72 hours. Ninety-one notes in SOAP format were reviewed and found a 27% physician response to dietitian recommendations. A review of OFD indicated 74% of dieititan recommendations were implemented by physicians. OFD has significantly improved physician response to dietitian recommendations at Saint Francis Medical Center due to clearly identified patient nutrition problems and a better understanding of the nutrition intervention process among the health care team.

A study of cost-effective and value of the dietetic internship program at the hospital setting

The value of the dietetic internship program at Saint Francis Medical Center was determined using six standard institutional criteria. They are: institution mission value, quality standard, financial measures, cost-effective and efficient operation status, community image/market position and community support. How the program complies with the criteria was analyzed and justified. As a result of the study, the Saint Francis Dietetic Internship Program is compatible with the institution mission value and high incidence of quality outcomes; provides extra flexible manpower for employee education, patient nutritional care, food service management functions and community services; and increased the visibility of the medical center. The internship program is an important factor in challenging and supporting the changes of the Food and Nutrition Services and also adds an essential element in the institution's educational plans. The program supports staff recruitment for the medical center, either from our own graduates or those from outside the state who are looking for challenging positions in teaching dietetics. The operational budget was able to cover expenses in a cost-effective and efficient manner. With proper planning of the curriculum, a systematic management approach, individualized experience content and the scheduling process, the program is able to meet the institution value standards and has been approved by the value committee without reservation.

Venous Thromboembolism and High Grade Gliomas

A retrospective study was done to determine the incidence of and the risk factors predisposing to clinical venous thromboembolism (VTE) in patients treated for high grade gliomas. Medical records of 68 consecutive patients diagnosed and treated at Saint Francis Hospital and Medical Center from January 1986 to June 1991 were reviewed. The follow up was to time of death or at least 6 months (up to December 1991). All clinically suspected episodes of VTE were confirmed by objective tests. Sixteen episodes of VTE were detected in 13 patients for an overall episode rate of 23.5%. Administration of chemotherapy (p = 0.027, two tailed Fisher exact test) and presence of paresis (p = 0.031, two tailed Fisher exact test) were statistically significant risk factors for the development of VTE. Thrombotic events were more likely to occur in the paretic limb and this difference was statistically significant (p = 0.00049, chi square test, with Yates correction). No major bleeding complications were seen in the nine episodes treated with long term anticoagulation. We conclude that venous thromboembolic complications are frequently encountered in patients being treated for high grade gliomas and the presence of paresis and the administration of chemotherapy increases the risk of such complications.

Clinical review 35: Growth factors and their potential clinical value.

Journal Article Clinical review 35: Growth factors and their potential clinical value Get access E Canalis E Canalis 1Department of Research, Saint Francis Hospital and Medical Center, Hartford, Connecticut 06105. Search for other works by this author on: Oxford Academic Google Scholar The Journal of Clinical Endocrinology & Metabolism, Volume 75, Issue 1, 1 July 1992, Pages 1–4, https://doi.org/10.1210/jcem.75.1.1618994 Published: 01 July 1992

Effectiveness of scalene node biopsy for staging of lung cancer in the absence of palpable adenopathy.

Scalene node biopsy (SNB) has been performed in patients with lung cancer at the Saint Francis Hospital and Medical Center if any of the following criteria has been present: (1) potentially resectable central lesion by chest radiograph, or (2) significant cardiac or pulmonary dysfunction, thereby placing the patient at increased risk for thoracotomy, or (3) a diagnosis of adenocarcinoma prior to SNB. Within these guidelines, a retrospective study was undertaken to determine the benefit of routine SNB in the absence of clinically palpable scalene nodes. In a 2-year period beginning April 1981, 56 patients (37 males) presented with radiographic evidence of lung carcinoma without clinical evidence of scalene adenopathy. Approximately half of the lesions were of a central position. While the majority had symptoms of cough, hemoptysis, or chest pain, the primary lung lesion was identified on routine chest radiograph in 15 (27%). In only three was there no history of smoking, the remainder having at least a 20-pack-year history of cigarette use. Following a routine evaluation, 57 SNBs were performed alone or in concert with other surgical procedures (mediastinoscopy, bronchoscopy). Of these, only two (3.5%) were diagnostic and indicative of unresectable disease. While in one patient no additional procedure was performed, a simultaneous Chamberlain procedure in the other confirmed that the patient was unresectable for cure. In the remaining patients, tissue diagnosis of cancer was obtained through other maneuvers. Because of the low probability that SNB in the absence of clinically palpable nodes altered the management of lung cancer, we do not believe it to be of benefit in the diagnosis or staging of this disease.

PRE-EXERCISE SCREENING IN ASYMPTOMATIC MALES AND FEMALES

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