PubMed HealthSearch

PubMed · 7779749

Clinical path coordinator: pulling it all together.

Abstract

Institutions across the country are using different approaches to restructuring health care delivery systems. At Lehigh Valley Hospital collaborative practice was instituted to ensure the achievement of patient outcomes within appropriate time frames and with efficient use of resources. The role of the clinical path coordinator emerged from the collaborative practice model developed to manage the care of the patient with an abdominal aortic aneurysm. The step-by-step process for selecting, orienting, and implementing the role of the coordinator is discussed. Since the implementation of the coordinator role, patient satisfaction has been positive, length of stay and cost have decreased, and quality of care has improved for these patients.

Explore related subjects

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

K A Boutron, J King, P Matula, C H Niznik. 1995. Clinical path coordinator: pulling it all together.. https://doi.org/10.1016/s1062-0303(05)80018-4

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

Comprehensive evaluation of differential expression of piRNAs in abdominal aortic aneurysm.

Abdominal aortic aneurysm (AAA) is a prevalent and fatal cardiovascular condition characterized by a high incidence rate and nonspecific clinical manifestations, with no effective preventive or therapeutic measures currently available. Piwi-interacting RNAs (piRNAs) have been identified as significant biomarkers for disease diagnosis due to their essential functions in transposon suppression, maintenance of genomic stability, immune response, and epigenetic modulation. The piRNA is intimately associated with various diseases such as cardiac hypertrophy, tumors, and neurodegeneration, yet its role in AAA is unclear. In this study, we employed gene sequencing to analyze the piRNA expression profiles in AAA vascular tissues and predicted variations in their target genes. Our findings revealed a total of 1368 piRNAs with abnormal expression in the AAA group relative to the control group, including 1240 up-regulated and 128 down-regulated piRNAs (|log2(fold change)|&#xa0;&#x2265;&#xa0;1.0), with 82 demonstrating significant differences (P&#xa0;<&#xa0;0.05). Through bioinformatics analysis, it was determined that the Wnt signaling pathway, calcium signaling, TNF-&#x3b1; and the p53 pathway are crucial mechanisms by which piRNAs contribute to the development of AAA. RT-qPCR confirmed that hsa_piR_011324 was the most significantly up-regulated piRNA in AAA (P&#xa0;<&#xa0;0.0001), corroborating RNA sequencing results. Further results indicate that hsa_piR_011324 promotes phenotypic transformation of human aortic vascular smooth muscle cells (HAVSMCs), enhances the activity of matrix metalloproteinases (MMPs), increased up-regulation of inflammation-related markers IL-1&#x3b2; and TNF-&#x3b1;, and induces apoptotic processes. In conclusion, the present study emphasizes the important regulatory role of hsa_piR_011324 in AAA, suggesting that it holds promise as a prospective target for diagnostic and therapeutic intervention.

Aortic Aneurysm, Abdominal

[A case report of aortoesophageal fistula due to thoracoabdominal aortic aneurysm].

Aortoesophageal fistulas due to thoracic aneurysms are usually fatal, with few reported survivors. A 57-year-old man with aortoesophageal fistula due to thoracoabdominal aortic aneurysm underwent the graft replacement of thoracoabdominal aorta. In the postoperative course, prosthetic graft infection had occurred in the result of residual esophageal fistula. On the 32nd postoperative day (POD), a subtotal esophagectomy was performed and the esophagus was reconstructed by gastrointestinal interposition technique via a retrosternal route. Following the second operative procedure, inflammatory reactions had been improved with systemic administration of antibiotics and continuous irrigation of the infected cavity. On 77th POD, he was discharged.

Aortic Aneurysm, Abdominal

Detection of type III collagen fragments in specimens of abdominal aortic aneurysms.

The purpose of this study was to analyze the collagens in aortic aneurysm walls and to investigate the mechanism of the formation of calcified abdominal aortic aneurysms (AAAs). Collagens were extracted from human aneurysmal aortic walls obtained during surgery, and from human nonaneurysmal aortic walls obtained at autopsy, using pepsin-acetic acid digestion. Electrophoresis and immunoblotting were performed. Type III collagen was found to be reduced in the arteriosclerotic aneurysmal aortic walls. The alpha1 chain of type II collagen/alpha1 chain of type I collagen ratio was 0.35+/-0.11 in the aortic aneurysms and 0.68+/-0.11 in the nonaneurysmal aortic walls (P=0.0111). All the calcified aneurysms were associated with type III collagen fragments having molecular mass of approximately 70 kDa and 30 kDa as estimated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Thus, we concluded that AAAs with calcification may be caused by an abnormal degradation of type III collagen.

Aortic Aneurysm, Abdominal