Percutaneous Management of Pyogenic Hepatic Abscesses

Twelve patients (9 men, 3 women) with a mean age of 65 (54-78) years, with pyogenic hepatic abscesses were managed by percutaneous drainage between 1979 and 1987. Biliary origin was most common (4 patients), followed by hepatic abscesses as a late postoperative complication (seen in 3 patients) and hepatic abscesses occurring in association with acute appendicitis (2 patients). The origin was unknown in 3 patients. Diagnosis was reached by computed tomography or ultrasonography with a diagnostic delay of in mean 11 days. Seventeen abscesses were found among the 12 patients. The median abscess size (maximal diameter) was 7 (1-12) cm. Nine patients were treated with percutaneous drainage with an indwelling catheter within the abscess cavity for up to 3 weeks, while 3 patients were managed with percutaneous puncture and aspiration alone. The most commonly isolated organism from the drained hepatic abscess was E. coli. The course following percutaneous treatment was uneventful, without mortality and recurrence of the hepatic abscess during follow-up. One patient required surgical drainage of an additional hepatic abscess. Percutaneous drainage of hepatic abscesses, independent of origin, thus seems as a safe and reliable method, which should be considered as the treatment of choice if facilities and knowledge of percutaneous management are provided

Metodutveckling av självskattningsformulär för prestationsmätning av flygledare innan skiftstart

This paper was part of the ongoing cooperation between the Swedish Civil Aviation Authority and the Department of Psychology at Lund University. The purpose of this study was to develop a self-report measure regarding human factors, for the air traffic controllers to fill out before they start their working shift. This in order to aid the team leaders in their judgment regarding the air traffic controller's ability to perform at the right safety level. The self-report measure would also serve as an aid for the air traffic controllers who have a responsibility regarding their own performance. If successful this self-report measure would make it easier for the air traffic controllers to be alert regarding certain factors that can have a large impact on their performance. The self-rating form is based on human factors such as home related stress, lack of sleep, psychosocial related work issues and the effects of working shift. These factors take place in non-working environments but can have a negative effect on the performance at work. The result showed that, even though the majority handled the human factors very well, some of the air traffic controllers felt that at least one of the human factors had a large negative influence on their performance. It had most impact if the air traffic controller was frustrated or felt dissatisfaction toward something at the workplace. Working with both administrative and operational tasks also had a large impact. Stress or fatigue did not seem to have that same amount of impact on their performance

Detection of hepatic metastases in colorectal cancer : A prospective study of laboratory and imaging methods

Objective: To assess and compare the accuracy of imaging methods (ultrasonography (US), computed tomography (CT), angiography, arterially enhanced CT with computed tomographic arterial portography (CTA)), biochemical analyses, and surgical assessment during the operation, in detecting the presence or absence of hepatic metastases in patients with colorectal cancer. Design: Open study. Setting: University of Lund, Sweden. Subjects: 71 consecutive patients without clinical evidence of liver metastases at the time of the operation for removal of the primary tumour. Interventions: Regular biochemical tests for five to seven years, and CT and US one year after operation in all patients without confirmed metastases. Main outcome measures: Presence or absence of hepatic metastases. Results: Accuracy of surgical assessment, angiography, US, CT and CTA was 90, 77, 80, 82 and 83%, respectively, and corresponding predictive values of a negative test were 87, 75, 77, 80 and 84%. Measurement of bilirubin concentration and hepatic enzyme activities were not helpful, and that of carcinoembryonic antigen had an accuracy of only 70%. Accuracy and predictive values were not improved by combining tests. Conclusion: The accuracy of US, CT or CTA was not good enough to merrit routine use before operations for colorectal cancer. They are potentially valuable for monitoring progress at follow up, but this remains to be confirmed