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Biomedical subjects

A W Humphries

Publications and source records attributed to A W Humphries.

17 recordsLinked to original sources
PubMed1991

Developing a quality assurance program for online services.

A quality assurance (QA) program provides not only a mechanism for establishing training and competency standards, but also a method for continuously monitoring current service practices to correct shortcomings. The typical QA cycle includes these basic steps: select subject for review, establish measurable standards, evaluate existing services using the standards, identify problems, implement solutions, and reevaluate services. The Claude Moore Health Sciences Library (CMHSL) developed a quality assurance program for online services designed to evaluate services against specific criteria identified by research studies as being important to customer satisfaction. These criteria include reliability, responsiveness, approachability, communication, and physical factors. The application of these criteria to the library's existing online services in the quality review process is discussed with specific examples of the problems identified in each service area, as well as the solutions implemented to correct deficiencies. The application of the QA cycle to an online services program serves as a model of possible interventions. The use of QA principles to enhance online service quality can be extended to other library service areas.

Computer Systems↗
PubMed1978

Acute intestinal ischemia.

The present mortality rate of more than 80% for patients with superior mesenteric arterial thrombosis or embolism will remain unacceptable until earlier diagnosis is achieved. Although leukocytosis is often an early feature and may seem elevated out of proportion to the severity of the illness, the later developments of abdominal rigidity, intestinal paralysis, and vascular collapse indicate transmural gangrene and peritonitis. At this stage, the eventual high mortality of acute ischemia is established whatever the urgency of the operation or the skill with which it is performed. The syndrome must be suspected immediately when a patient in an older age group complains of sudden abdominal pain in the presence of associated cardiac arrhythmia, valvular disease or congestive heart failure, particularly if other sites of peripheral embolization are identified.

Acute Disease↗
PubMed1977

Chronic intestinal ischemia.

Fifteen patients with chronic ischemia of the intestine underwent mesenteric revascularization at the Clinic between 1964 and 1975. Diagnosis was established by strict interpretation of historical and physical findings and the results of lateral abdominal aortography. Three patients had acute ischemia of the intestine immediately following diagnostic arteriography and an operation was required immediately. Vascular reconstruction of selected visceral arteries included the insertion of a bypass graft, endarterectomy and reimplantation of the superior mesenteric artery. Ten of the 15 patients had clearly good results, one patient had only fair relief and four patients had poor results, with one operative death. Surgical results of mesenteric revascularization, in large measure, reflect the accuracy of preoperative diagnosis and patient selection.

Adult↗
PubMed1976

Unoperated, asymptomatic significant internal carotid artery stenosis: a review of 182 instances.

One hundred and sixty-eight asymptomatic patients with a carotid artery stenosis of more than 50% were observed over a period of up to 12 years. During this time, 136 patients remained asymptomatic, two patients developed atypical neurologic symptoms that spontaneously disappeared, 26 patients developed transient ischemic attacks and successfully underwent carotid endarterectomy, three patients developed transient ischemic attacks that were ignored and they subsequently suffered a completed stroke, and one patient suffered a completed stroke without a warning transient attack. These data suggest that surgery is not required in the patient with an asymptomatic carotid stenosis until a transient ischemic attack occurs.

Aged↗
PubMed1975

The ischemic leg: a clue to dissecting aneurysm.

The acute ischemic leg may be an important clue to the diagnosis of a dissecting aneurysm. Seventeen of 65 patients with dissecting aneurysms presented with this picture. The ischemic leg was often the dominant feature and obscured the correct diagnosis. The possibility of aortic dissection should be considered in any patient with an acutely ischemic leg, especially if there is any accompanying chest, neck, or back discomfort. The presence of an ischemic limb is not necessarily an indication for surgical repair of the dissection itself. Of seven patients treated medically, five survived with limbs intact, and in all five the pulses returned within one month.

Adult↗
PubMedDate not supplied

Carotid compression tonography. Correlation with bilateral carotid arteriography in the diagnosis of extracranial carotid occlusive disease.

One hundred twenty two patients ahd carotid compression tonography (CCT) followed by bilateral carotid arteriogaraphy. Inthe group (82 patients) which was felt to have significant occlusive disease of internal carotid at the level of carotid bifurcation (smaller than 50 percent stenosis), the CCT showed a 92 per cent correlation with arteriography. Of the group (48 patients) that underwent endarterectomy, there was a 94 per cent correlation with CCT testing. In 40 patients, with normal arteriogram or with less than 50 percent stenotic lesions on arteriography, there was a larger number (25% of patients with a CCT test which appeared to indicate decreased flow. Various reasons for this are discussed. The high correlation of the CCT test and carotid arteriography in the patients with surgically amenable lesions would suggest that the CCT test is a good noninvasive screening technique for the detection of significant occlusive disease of the extracranialcarotid vascular system.

Angiography↗