Providing clinicians with information on laboratory test costs leads to reduction in hospital expenditure

Objectives. We aimed to ascertain the efficacy of an intervention in which laboratory test costs were provided to clinicians as a pocketsized brochure, in reducing laboratory test costs over a 4-month eriod. Methods. This was a non-randomised intervention study in the Internal Medicine wards at Steve Biko Academic Hospital, Pretoria, in which the intervention was laboratory test costs provided to clinicians as a pocket-sized brochure. The intervention period was the winter months of May - August 2008 and the pre-intervention period was the same months of the preceding year. In the two 4-month periods (2007 and 2008), the number of days in hospital and the laboratory tests ordered were computed for each patient admitted. For the intervention and control groups, pre- and postintervention cost and days in hospital were estimated. Results. The mean cost per patient admitted in the intervention group decreased from R2 864.09 to R2 097.47 – a 27% reduction. The mean cost per day in the intervention group as a whole also decreased, from R442.90 to R284.14 – a 36% reduction. Conclusion. Displaying the charges for diagnostic tests on the laboratory request form may significantly reduce both the number and cost of tests ordered, and by doing so bring about considerable in-hospital cost savings

Conned by Conn’s Syndrome

Conn’s Syndrome is a rare entity amongst hypertensive patients and imaging of the aldosterone producing adenoma (APA) can prove challenging but is none the less very important for surgical planning and cure. We present two patients with MRI confirmation of APA with negative and equivocal computed tomography (CT) scans

Ultrasound - first imaging modality in the detection of parathyroid adenomas

Abstract We present a series of 12 patients in whom the typical ultrasound features of parathyroid adenomas were accurately demonstrated. High resolution ultrasound [in experienced hands] is a highly sensitive accurate, safe and non invasive method of localizing parathyroid adenomas especially in patients with typically located glands and an absence of thyroid pathology. Our aim was to compare ultrasound with nuclear medicine as an imaging gold standard in patients with thyroid adenomas

Extramedullary haematopoeisis causing spinal cord compression

Extramedullary haematopoeisis (EMH) is a rare cause of spinal cord compression. However, in a patient with a haematological disorder and in particular thalassaemia, EMH with paraspinal masses should be considered and imaging planned appropriately