Biomedical subjects
R Dailey
Publications and source records attributed to R Dailey.
Orbital aneurysmal bone cyst in a patient with renal cell carcinoma.
A 43-year-old man with presumed renal cell carcinoma who was found to have an asymptomatic hot spot in his right zygoma on a bone scan during a metastatic evaluation. At the time of nephrectomy, an excisional biopsy of the lateral orbital wall was performed to rule out solitary metastasis of his renal cell carcinoma. The lateral wall was reconstructed with a rib autograft and multiple rigid fixation. Histopathologic examination of the specimen showed a fibrous matrix with large, dilated, sinusoidal, vascular channels typical of an aneurysmal bone cyst. In the absence of metastasis, the five-year survival rate is approximately 90% with nephrectomy alone.
Development of the 'Activities of Daily Vision Scale'. A measure of visual functional status.
To develop a method for the evaluation of visual function in subjects with cataracts, the authors identified 20 visual activities and categorized them into five subscales (distance vision, near vision, glare disability, night driving, and daytime driving) that comprised the Activities of Daily Vision Scale (ADVS). Each subscale in the ADVS was scored between 100 (no visual difficulty) and 0 (inability to perform the activity because of visual difficulty). In 334 subjects scheduled for cataract extraction (mean age 75 +/- 9 years, 67% women), ADVS scores (mean +/- standard deviation) for each subscale ranged from 44 +/- 31 for night driving to 72 +/- 24 for near vision activities. When administered by telephone, inter-rater reliability coefficients (r) were 0.82 to 0.97 (P < 0.001) for each of the subscales, and test-retest reliability was 0.87 for the scale overall. Cronbach's coefficient alpha was very high for both the in-person (alpha = 0.94) and telephone (alpha = 0.91) formats. Criterion validity, the correlation between visual loss and ADVS score, was -0.37 (P < 0.001) when the ADVS was administered in person and -0.39 (P < 0.001) when it was administered by telephone. Content validity as assessed with factor analysis showed that 88% of the variance of the principal components weighted on one factor. The authors conclude that substantial visual disability is not captured by routine visual testing and that the ADVS is a reliable and valid measure of patient's perception of visual functional impairment.
Empowering middle managers in hospitals with team-based problem solving.
A team-oriented problem-solving procedure using management project teams was developed to improve quality of care and productivity in a private, nonprofit hospital. A focus group of managers developed the procedure, endorsed by top management. The work of four manager teams that followed the procedure saved the hospital more than $500,000.
Ovariectomy of newborn rats: a descriptive surgical procedure.
The ovaries of newborn rats were removed through an opening in the external abdominal oblique muscle, lateral to a dorsal midline skin incision. This approach diminished the incidence of postsurgical hernia by avoiding the exertion of intraabdominal pressure and visceral weight on a ventral midline incision. Loss of abdominal fluid, which usually occurs with ventral midline incision, also was avoided.