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PubMedDate not supplied

Assessment of glycosylated hemoglobin measurement with sample collection papers.

It would be advantageous to be able to measure glycosylated hemoglobin (GHb) from a sample of blood dried on paper and sent to the physician by the patient. Indeed, such a technique has been introduced by Isolab (Akron, OH). We tested the validity of the method to determine whether applying the blood to paper and immediately assaying it correlates with the same sample assayed by the usual whole-blood technique, the size of sample applied to paper affects apparent GHb results, time and temperature of storage of the sample paper affect apparent GHb results, and plasma glucose concentration of the sample affects GHb results. The GHb of samples assayed immediately after application to sample paper versus those assayed as whole blood showed very good correlation (r = .93, P less than .001). Volume of the drop of blood applied to paper (25-100 microliters) did not affect results. However, there was a dramatic, temperature-dependent increase in apparent GHb when samples were stored on sample paper, averaging 12.5, 16.3, and 19.5% when stored at room temperature for 3, 6, and 9 days, respectively. Overall, apparent GHb rose from 1.3-fold in 3 days at 4 degrees C to 3.8-fold in 9 days at 37 degrees C. The rate of GHb formation was proportional to plasma glucose concentration, but removal of free glucose by ethanol or glucose oxidase did not yield consistent results for this method. We conclude that these sample papers are not useful as an approach to collecting blood samples for GHb measurement.

Blood Glucose↗
PubMed1988

Interactional variables associated with retention and success in residential drug treatment.

The present study was designed to identify variables associated with client retention and success at the Rocco Antenucci Memorial Adult Residential Drug Treatment Center in Akron, Ohio. Multiple stepwise regressions were utilized to evaluate the variance contributed by demographic, psychological, and interactional variables associated with client retention for 100 program participants. Degree of social support and employment at discharge accounted for 63% of the variance. Factors related to successful treatment completion, identified using the Kruskal-Wallis one-way analysis of variance, included: involuntary admission, family involvement in treatment, degree of social support, and employment at discharge.

Adolescent↗
PubMed1999

[Epidemiological observations on the first case of human paragonimiasis and potential intermediate hosts of Paragonimus sp. in Benin].

Parasitological investigations were carried out for four months in 1998 in two Beninese centres of pneumo-phtisiology (Akpakpa, at Cotonou, and Akron, at Porto-Novo) to detect the patients harbouring eggs of Paragonimus sp. amongst the persons consulting for tuberculosis and showing a broncho-pneumopathy without mycobacteria. Eggs of Paragonimus sp. were detected in the sputum of a single patient out of 369 persons examined (prevalence, 0.2%). This patient had eaten crabs in the months preceding the date of diagnosis. A treatment using praziquantel has improved clinical symptomatology and biological signs found in this patient. These studies have been completed by visiting markets located in the coastal plain of Benin to identify the crabs that were sold and to find metacercariae of Paragonimus sp. Negative results were obtained when 126 Cardisoma armatum ("hole crab") were dissected. In contrast, the dissection of 176 Callinectes marginatus ("swimming crab") was successful, with 5% of crabs harbouring metacercariae of probably Paragonimus sp. Further studies are necessary to confirm these first results and to determine the global prevalence of Paragonimus infection in these definitive and intermediary hosts.

Aged↗
PubMed1999

More space, more speed. Scanning technology and COLD help improve document imaging.

UNLABELLED: Children's Hospital Medical Center, Akron, Ohio PROBLEM: The 100-year-old-plus medical center needed a reliable, economical and easy-to-use document storage method that provided a long and secure archival life. SOLUTION: Children's adopted Hewlett-Packard magneto-optical jukeboxes and Optika software. RESULTS: Since the jukeboxes became operational in January 1998, Children's has maintained "24 x 7 availability" of its stored documents for up to 150 concurrent users without any downtime. KEYS TO SUCCESS: "We started implementation in the accounting department with patient billing, hospital general ledger, accounts payable and employee payroll, and the document imaging system has quickly gained acceptance in other departments as well."

Hospital Information Systems↗
PubMedDate not supplied

Ohio hospital PR pros collaborate on crisis communications plan.

Two member hospitals of the Akron Regional Hospital Association (ARHA), Ohio, experienced crisis situations which severely strained their public relations resources. These events were the genesis for the development of a comprehensive plan for sharing public relations resources among 11 member hospitals. The plan details procedures for sharing help in the event of a crisis or specific hospital media event. It identifies three potential situations in which it can be implemented: internal disaster, external disaster, or a specific incident unique to one of the hospitals. No occasion has yet arisen to implement the plan.

Communication↗
PubMed1953

History of the prevention of endemic goitre.

The importance to the community of the prevention of endemic goitre-a food-deficiency disease which causes feeble-mindedness, deaf-mutism, and general physical and mental degeneration from one generation to the next-and the simplicity of prevention, have only gradually been realized in the course of the past hundred years. In the early 19th century, potassium iodide was used in goitre prevention, but the experiment was abandoned about the year 1858. The first controlled experiment was made in 1916-20, when a course of sodium iodide followed by 5,000 schoolgirls in Akron, Ohio, USA, proved 100% efficacious against the development of the disease. An investigation of the 20th-century development of endemic goitre in West Virginia, USA, carried out in 1922, established a direct connexion between the abandonment of the use of locally available natural iodized salt and the development of a high incidence of endemic goitre in an area hitherto goitre-free. In 1924, an attempt to eliminate endemic goitre by replacing plain salt by iodized salt was made in the State of Michigan, USA. The experiment was at first resisted by the goitre surgeons; opposition was finally dispelled when a survey, carried out in the State four years later, proved that not one case of toxic goitre due to the consumption of iodized salt had occurred in three counties chosen as the test area. As a result of analyses made at a follow-up survey in 1936, it was recommended that all iodized salt be standardized at 0.01% of iodine. Since iodized salt is more expensive to produce than plain salt, support of the medical profession alone is not enough. Co-operation on the part of both governments and business is essential if iodized salt is to become available throughout the world at as low a price as plain salt. Recent experience in Argentina, where the introduction of iodized salt was accompanied by a prohibitive increase in selling price, illustrates this necessity.

Biomedical Research↗
PubMed2004

SARS Surveillance Project--Internet-enabled multiregion surveillance for rapidly emerging disease.

INTRODUCTION: On March 15, 2003, CDC requested health-care and public health agencies to conduct surveillance for severe acute respiratory syndrome (SARS). The SARS Surveillance Project (SARS-SP) was established to rapidly implement multiregional SARS surveillance in emergency departments (EDs) by using existing Internet-based tools. OBJECTIVES: The objectives of SARS-SP were to 1) disseminate and update SARS screening forms for ED triage, 2) establish surveillance for SARS syndrome elements by using Regional Emergency Medicine Internet (REMI), 3) expand surveillance to multiple regions, and 4) evaluate the usefulness of Internet tools for agile surveillance during a rapidly emerging global epidemic. METHODS: SARS-SP developed, distributed, and updated an Internet-based triage form to identify patients for infection control and public health reporting. EDs then were invited to report visit frequencies with various SARS syndrome elements to local public health authorities by using the REMI Internet application (first in one metropolitan area, and later in four). After pilot-testing in one metropolitan area, the surveillance system was implemented in three others. RESULTS: Active syndromic surveillance was established by health departments in Milwaukee, Wisconsin; Denver, Colorado; Akron, Ohio; and Fort Worth, Texas. A total of 27 EDs reported syndrome frequencies from >146,000 patient encounters. CONCLUSIONS: ED and public health partners reported being satisfied with the system, confirming the usefulness of Internet tools in the rapid establishment of multiregion syndromic surveillance during an emerging global epidemic.

Communicable Diseases, Emerging↗
PubMed1991

The Greenfield filter as the primary means of therapy in venous thromboembolic disease.

During a five year period at Akron City Hospital, 165 Greenfield filters were placed in 165 patients. Of this group, 78 patients were available for long term analysis, and of these, 42 did not receive anticoagulation treatment for venous thromboembolic diseases, either acutely or on an outpatient basis. An analysis of the outcome for these 42 patients who had the Greenfield filter only as the primary mode of therapy for the disease included chart review and asking each person a standard set of questions. Leg swelling was the most common complaint, occurring in 33 per cent of patients. Venous stasis ulceration occurred in two patients and recurrent deep venous thrombosis occurred in one patient. When compared with a historical control group with venous thromboembolic disease that was treated with anticoagulation alone, the incidence of these sequelae in Greenfield-treated patients was not significantly different. Finally, in this review, the Greenfield filter is better than 95 per cent effective in the prevention of pulmonary embolism. This is no less effective than anticoagulation alone, the efficacy of which is 95 to 98 per cent. The placement of a Greenfield filter is a safe procedure that can usually be done after a local anesthetic was administered to the patient with a complication rate of less than 10 per cent. Unfortunately, major complications of anticoagulation (usually hemorrhage) are relatively common at a rate of 2 to 15 per cent, and occur more frequently in the older population. It is for reasons of safety of therapy and of an equal or better efficacy that the Greenfield filter is recommended in a broader range of clinical circumstances. In particular, it is concluded that the Greenfield filter should be used as a primary means of therapy in venous thromboembolic disease, particularly in those patients who are more than 65 years of age, when the risks of anticoagulation are most threatening.

Adult↗
PubMed1991

The evolution of surgical endoscopic training. Meeting the American Board of Surgery requirements.

The American Board of Surgery requires that applicants become familiar with gastrointestinal endoscopy. This report retrospectively reviews Akron City Hospital's ten-year experience in surgical endoscopic training. In July, 1982, a two-month endoscopy rotation was established for fourth-year surgical residents. The average number of endoscopies performed by the resident as surgeon increased from 49.0 in 1984-85, to 167.7 in 1988-89. The percentage of endoscopies performed as surgeon increased from 46.4 per cent to 87.3 per cent during the same period. These increases are coincident with the addition of two trained surgical endoscopists to the faculty. This improvement in resident experience is attributed to an increase in endoscopies performed by faculty surgeons (634 procedures in 1988-89 vs. 291 procedures in 1984-85), and to an increase in percentage of procedures performed as surgeon with faculty gastroenterologists. Two of the three residents graduating in the final year of the study met the SAGES guidelines for upper GI endoscopy and colonoscopy. Based upon this ten-year experience, we recommend that surgical residencies desiring to develop endoscopic training recruit trained surgical endoscopists and develop a collaborative relationship between medical and surgical faculty.

Endoscopy, Digestive System↗
PubMed1989

[Clinico-pathological studies on the effects of calcium hydroxide eugenol preparations to the human vital pulp tissues].

The present paper reports results of a study to evaluate clinico-pathologically the effects of calcium hydroxide eugenol preparations on exposed pulp tissues in permanent human teeth. The experiments were performed on 80 vital human teeth from patients ranging in age from 12 to 54 years. The experimental teeth were arbitrarily divided into the following 4 groups. Group CRCS: 20 cases treated with CRCS (Hygienic, Akron, Ohio, USA). Group KEZ: 20 cases treated with Dentalis KEZ (Neo Dental Chemical Products, Tokyo, Japan). Group CE: 20 cases treated with calcium hydroxide eugenol (positive control) Group E: 20 cases treated with pure eugenol (negative control). After local anesthesia, the experimental teeth were isolated with rubber dums or cotton rolls. Following preparation of Black's simple class 1 cavities with a diamond instrument mounted high-speed air turbine, the pulp was intentionally exposed by means of a steel bur mounted electric engine. The cavity and exposed pulp surface were cleaned with saline and dried on absorbent material. Then the experimental materials (agents) were applied to exposed pulp surface. The cavity was lined with gutta-percha temporally stopping, and the remainder was filled with silver amalgam. The teeth were clinically observed at various intervals from immediately to 530 days after treatment and then extracted under local anesthesia and prepared for histopathological study. Decalcified sections were stained with hematoxylin and eosin. 1) CLINICAL OBSERVATIONS: During the observation period, symptoms occurred in the following: Group CRCS: 4 (20%) out of 20 cases. Group KEZ: 4 (20%) out of 20 cases. Group CE: 6 (30%) out of 20 cases. Group E: None of 20 cases No spontaneous pain was observed in these groups. 2) Clinical evaluations Group: CRCS: 16 cases (80%) were good, 3 cases (15%) were satisfactory, and 1 cases (5%) were failure. Group KEZ: 16 cases (80%) were good, 1 cases (5%) were satisfactory, and 3 cases (15%) were failure. Group CE: 14 cases (70%) were good, 4 cases (20%) were satisfactory, and 2 cases (10%) were failure. Group E: 20 cases (100%) were good. 3) Histopathological observations. Various kinds and degree of pulp changes were occurred in each group. Hyperemia and round-cell infiltration resulting from damage caused by treatment and medicaments were frequent in each group. No suppurative inflammation occurred in group CE. Pulp cicatrization and apposition of dentin on pulp chamber walls were observed frequently in each groups. Hard tissue formation was observed in numerous cases of group CE and in some cases in group CRCS and KEZ.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗
PubMed1988

Changing concepts of deep venous thrombosis of the upper extremity--report of a series and review of the literature.

Deep venous thrombosis (DVT) of the upper extremity has recently been recognized as being more common than previously reported (probably because of the increasingly frequent use of subclavian venous access). A retrospective review of patients in whom subclavian or axillary DVT had developed in the past 6 years (1980 to 1986) was conducted at the Akron General Medical Center. The major cause identified was related to subclavian venous catheterization, which accounted for 39% of all instances of subclavian and axillary DVT. Our results are correlated with a review of the literature. In our review of studies in which subclavian venous catheterizations were prospectively examined with use of objective means of diagnosis, we found that 28% of all subclavian catheterizations had venous thrombosis develop, often subclinically. This is not an innocuous disease, as suggested in the past; in our series 12% of upper-extremity DVT had pulmonary embolization (PE). In reviewing the recent literature, we found an average 12.4% incidence of PE, which often occurs during anticoagulation treatment. Diagnostic modalities are discussed and treatment regimens are reviewed along with an extensive literature review.

Arm↗
PubMed1986

Marketing: the creative advantage.

Success is celebrated best by sharing the process that led to its achievement. The marketing of nursing products at the 507-bed Akron General Medical Center is a success worth sharing with other nurse executives. The authors describe the marketing process that generated new sources of revenue to support staff education and clinical specialist services.

Hospital Bed Capacity, 500 and over↗
PubMed1977

The physician as manager. "What" and HOW" OF PRACTICE MANAGEMENT EDUCATION.

Management science and application play a pivotal role in preparing physicians for effective and efficient office practice. Integration of management theory into practice management education of family physicians may be accomplished by developing and maintaining a well-organized model practice, involving residents directly in management decisions and problem solving, using a variety of resource people in and outside the model unit, and providing quantitative analysis of practice performance. After three years of development, the Family Practice Center of Akron City Hospital has instituted a practice management curriculum whereby residents become actively involved in the management and supervision of the model practice, conduct research study into management problems, and receive training and supervision as they develop leadership and organizational skills.

Audiovisual Aids↗
PubMedDate not supplied

How patients view mandatory waiting periods for abortion.

In recent years, various legislatures have enacted laws and ordinances mandating a waiting period for women seeking to obtain abortions. Legal challenges to such statutes have been successful, except in one instance (Akron, Ohio), and a federal judge in Tennessee recently struck down a waiting period statute. As part of the appeal against the Tennessee law, two surveys were made of some 400 women who experienced such a delay to probe their opinions about the benefits and drawbacks of the mandated waiting period. More than seven in 10 women were unable to name a single benefit to be derived form waiting, and six in 10 pointed to one or more problems they had experienced, including extra expense, missed work or school, experiencing some discomfort and entering the second trimester of pregnancy, among others. About +7,6000 in extra expenses were incurred by about 200 of the women (with a median of +24 per woman), adding about 48 percent to the costs for the typical low-income woman and 14 percent for the typical higher income woman. The cost of the second visit increased in direct proportion to the distance a woman lived from the family planning clinic and to the number of hours she was employed per week. The typical woman was found to hold a negative view of the statute. Women who were surveyed before and after the waiting period said that they actually realized fewer benefits and experienced more problems from the waiting period than they had anticipated.

Abortion Applicants↗
PubMed1993

Promoting activity in the elderly through interdisciplinary linkages.

Interdisciplinary collaboration helped a group of health care providers plan, implement, and evaluate an exercise program for sedentary older adults in a long-term care facility. The program, designed as a research study, can be implemented by paraprofessional care givers with minimal supervision. The synergy resulting from collaboration between the investigator and colleagues in the practice arena was the cornerstone of the program's success. This paper describes the results of a Sit and Get Fit exercise program, a project funded by The University of Akron.

Aged↗
PubMed1994

The AHA's NOVA awards. Making collaboration work.

What do communities as diverse as Akron, OH, Colville, WA, Laconia, NH, Denver and Philadelphia have in common? They all have health care organizations involved in collaborative activities among providers and between providers and community groups. And for their achievements, those organizations are recipients of the AHA's NOVA Award.

Adolescent↗