Biomedical subjects

P Eason

Publications and source records attributed to P Eason.

24 records · Page 2Linked to original sources

PubMedDate not supplied

Severity adjustment for length of stay: is it always necessary?

OBJECTIVE: Severity adjustment is an oft-cited requirement when comparing physicians or medical delivery systems. Each application of severity adjustment, however, has to be tested to validate the need, the method, and its value. We examined the value of severity adjustment for identifying physician outliers when studying length of stay in the hospital. DESIGN: We compared the placement of physicians in an outlier category using a severity-adjusted average length of stay (SLOS) index with their placement using the unadjusted average length of stay (ALOS). Changes in placement of the list were validated by the utilization review coordinators. SETTING: A 614-bed tertiary-care university teaching hospital. SUBJECTS: We analyzed 11,146 discharges from 138 physicians in 1992. RESULTS: The mean ALOS +/- standard deviation was 9.05 + 4.50 days, and the SLOS Index was 7.56 +/- 3.06. There were 120 inliers, 6 high outliers, and 12 low outliers by the ALOS method. Using the SLOS index, 27 of 138 physicians had their categories changed from inlier to outlier or from outlier to inlier. The difference in group changes was more significant for those going from outlier to inlier status (8/120 vs 6/18; P < .001). The patients of the six physicians whose status changed from outlier to inlier status were sicker, as indicated by the comorbidity, complications, and manifestations of disease processes score. The utilization reviewers validated the status changes in 8 of 14 instances. CONCLUSIONS: Severity-adjusted length of stay by the SLOS index appears to provide a more accurate measure than the unadjusted ALOS. The changes, however, were small. It is not clear that the added effort is worthwhile.

Hospital Bed Capacity, 500 and over↗

PubMedDate not supplied

A simple fluorescent technique for screening cervical cells prior to nuclear analysis.

Monolayer spreads of cervical cells were prepared and stained with haematoxylin and rhodamine-alpha-N-agmatine, a fluorescent marker for a cell surface protease. Mature epithelial cells from normal cervices lacked this cell surface enzyme and did not fluoresce. The abnormal cells possessed the cell surface enzyme, bound the probe and were quickly detected by fluorescence microscopy. The degree of abnormality of these fluorescent cells was determined by examination of their nuclear details, with the result that mild, moderate and severe dyskaryotic cells could be defined.

Agmatine↗

PubMedDate not supplied

Ellipse test for the reduction of false positive signals in automated cytology.

One of the major problems in automated cytology is the elimination of false positive 'abnormal cell' alarms caused by objects such as overlapping cell pairs, leukocyte clusters, etc. The paper describes an algorithm for the separation of images of abnormal cell nuclei and non=nuclear objects in computer image analysis systems for automated cytology. The algorithm involves the measurement of the agreement between the object outline and a computer ellipse of equal area, aspect ratio and orientation. Results obtained with the CERVISCAN experimental computer image analysis system show that the algorithm gives good discrimination between abnormal cell nuclei and typical non-nuclear objects found in cervical scrape specimens prepared specially for automated analysis.

Cell Nucleus↗

PubMedDate not supplied

Correlation of cell surface fluorescence with conventional PAP analysis of cells of cytological interest obtained from cervical scrapes.

Archival PAP stained cervical smears were destained and treated with a fluorescent probe for a cell surface enzyme (GB). Cells which exhibited cell surface fluorescence were demonstrated to be cells of cytological interest in the analysis of cervical smears. These cells could be directly related to PAP and reclassified by subsequent restaining with PAP. Fluorescent cell surface technology was shown to be compatible with conventional PAP staining.

Cervix Uteri↗

PubMedDate not supplied

A protein inhibitor, extracted from Hela cells, which recognises a cell surface protease on preneoplastic cells obtained from cervical smears.

Hela cells originate from a clone of cervical carcinoma cells. The cytoplasm of Hela cells contains a protein which recognises and inhibits a proteolytic enzyme (guanidino-benzoatase) on the surface of Hela cells. This same protease is present on the surface of abnormal epithelial cells obtained from cervical smears, enabling a rhodamine labelled inhibitor extracted from Hela cells to locate abnormal cervical cells in monolayer spreads.

Biomarkers, Tumor↗

PubMedDate not supplied

The application of double fluorescence to the rapid selection of atypical cervical epithelial cells spread in monolayers.

Monolayer spreads of cervical cells were prepared and reacted in sequence with two fluorescent probes. The nuclei were reacted with 4,6-Diamidino-2-phenylindole (DAPI), resulting in white fluorescence of all cell nuclei. Those cells possessing active guanidinobenzoatase (GB) bound the second probe, rhodamine-alpha-N-agmatine (Rh-Agm), resulting in orange cell surface fluorescence. Atypical epithelial cells possessed both active GB and enlarged nuclei; such cells could easily be recognised by their cytological appearance. We illustrate our results in the form of colour prints which are representative of our observations of cells in both normal and abnormal cervical spreads.

Agmatine↗