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Southern Medical Journal

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https://www.readbyqxmd.com/read/28575905/association-of-white-matter-lesions-cerebral-atrophy-intracranial-extravascular-calcifications-and-ventricular-communicating-hydrocephalus-with-delirium-among-veterans
#1
Mark B Detweiler, Rathnakara M Sherigar, Geoffrey Bader, Kelly Sullivan, Arline Kenneth, Naciye Kalafat, Pavan Reddy, Brian Lutgens
OBJECTIVES: The literature regarding the underlying neuropathogenesis of delirium on head computed tomography (CT) is limited. The aim of this research was to investigate, using case-control retrospective chart review, the association of white matter lesions (WML), cerebral atrophy, intracranial extravascular calcifications, and ventricular-communicating hydrocephalus in older adult military veterans with and without delirium hospitalized in a Veterans Affairs Medical Center. METHODS: Head CT scans were examined for WML, atrophy, and intracranial extravascular calcifications globally in the cortex, subcortex (frontal, temporal, parietal, occipital lobes), basal ganglia (globus pallidus, caudate, putamen), and internal capsule, in addition to the presence of ventricular-communicating hydrocephalus...
June 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28575904/commentary-on-do-mixed-flora-preoperative-urine-cultures-matter
#2
R Keith Huffaker
No abstract text is available yet for this article.
June 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28575903/do-mixed-flora-preoperative-urine-cultures-matter
#3
Michael R Polin, Amie Kawasaki, Cindy L Amundsen, Alison C Weidner, Nazema Y Siddiqui
OBJECTIVES: To determine whether mixed-flora preoperative urine cultures, as compared with no-growth preoperative urine cultures, are associated with a higher prevalence of postoperative urinary tract infections (UTIs). METHODS: This was a retrospective cohort study. Women who underwent urogynecologic surgery were included if their preoperative clean-catch urine culture result was mixed flora or no growth. Women were excluded if they received postoperative antibiotics for reasons other than treatment of a UTI...
June 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28575902/can-computers-be-made-to-respect-the-art-of-medicine
#4
Neil J Nusbaum
No abstract text is available yet for this article.
June 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28575901/dissemination-approaches-to-participating-primary-care-providers-in-a-quality-improvement-program-addressing-opioid-use-in-central-appalachia
#5
Roberto Cardarelli, Charlotte Sue Workman, Sarah Weatherford, Stacey Whanger, Dana E King
OBJECTIVES: Practice-based research networks (PBRNs) have been described as new clinical laboratories for primary care research and dissemination. PBRNs, however, have struggled to disseminate research results in a meaningful way to participating providers and clinics. METHODS: The Central Appalachia Inter-Professional Pain Education Collaborative was developed to work with PBRN clinics using quality improvement methods, deliver statewide continuing education activities to address the issue of opioid use in patients with chronic pain, and develop a multimodal mechanism to disseminate project results to clinics and participating providers...
June 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28575900/commentary-on-effects-of-a-12-month-educational-intervention-on-clinicians-attitudes-practices-regarding-the-screening-spiritual-history
#6
Michael P McCarthy
No abstract text is available yet for this article.
June 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28575899/effects-of-a-12-month-educational-intervention-on-clinicians-attitudes-practices-regarding-the-screening-spiritual-history
#7
Harold G Koenig, Kathleen Perno, Alaattin Erkanli, Ted Hamilton
OBJECTIVES: Patients' spiritual values, beliefs, and preferences are identified in outpatient medical settings by the taking of a screening spiritual history (SSH). We report the impact of an educational/training program on the attitudes/practices of physicians (MDs) and midlevel practitioners (MLPs). METHODS: A convenience sample of 1082 MDs or MLPs in outpatient practices was approached to participate in a 12-month educational/training program in this single-group experimental study...
June 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28575898/colon-cancer-screening-in-concierge-practice
#8
Elizabeth Nguyen, Shivani Mehta, Scott W Yates, M Keith Schrader, Michael C Martin
OBJECTIVES: This study evaluated the effectiveness of the Center for Executive Medicine (CEM) concierge primary care practice on preventive colorectal cancer (CRC) screening rates relative to local and national comparator data. METHODS: We performed an electronic medical record search encompassing our entire patient population who are between the ages of 50 and 75 years to determine the rate of CRC screening. We compared this rate with the average rate of Medicare Advantage plans reported by our Independent Physician Association (IPA) in 2015 and national health plans reported by the National Committee for Quality Assurance in 2014...
June 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28575897/effect-of-diet-liberalization-on-bowel-preparation
#9
Danny J Avalos, Daniel A Sussman, Luis F Lara, Fayez S Sarkis, Fernando J Castro
OBJECTIVES: Precolonoscopy dietary regimens often are restricted to clear liquids; however, the superiority of a clear liquid diet (CLD) for bowel preparation quality is ambiguous. We performed a meta-analysis of randomized trials comparing bowel preparation outcomes between a low-residue diet (LRD) or regular diet (RD) compared with a CLD. METHODS: MEDLINE, clinicaltrials.gov, Cochrane Central Register, Scopus, Embase, Cumulative Index to Nursing and Allied Health Literature, and the Web of Science databases were used to conduct a search for randomized controlled trials from 1976 to March 2015...
June 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28575896/pirfenidone-and-nintedanib-for-treatment-of-idiopathic-pulmonary-fibrosis
#10
Gayathri Sathiyamoorthy, Sameep Sehgal, Rendell W Ashton
Idiopathic pulmonary fibrosis is one of the most common entities of the family of disorders known as the interstitial lung diseases. It is a chronic, progressive, and often-fatal disease with a median survival time of 3 to 5 years. In 2014 the US Food and Drug Administration approved pirfenidone and nintedanib, two antifibrotic agents for the treatment of idiopathic pulmonary fibrosis. Because these are the only drugs approved that can alter the course of this rare but fatal disease, this article reviews the major studies that led to the approval of these drugs and examines the indications for treatment and the expected outcomes of therapy...
June 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28464184/on-battlefield-acupuncture-is-it-ready-for-widespread-dissemination
#11
Daniel G Federman
No abstract text is available yet for this article.
May 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28464183/physician-satisfaction-in-treating-medically-unexplained-symptoms
#12
Simon G Brauer, John D Yoon, Farr A Curlin
OBJECTIVES: To determine whether treating conditions having medically unexplained symptoms is associated with lower physician satisfaction and higher ascribed patient responsibility, and to determine whether higher ascribed patient responsibility is associated with lower physician satisfaction in treating a given condition. METHODS: We surveyed a nationally representative sample of 1504 US primary care physicians. Respondents were asked how responsible patients are for two conditions with more-developed medical explanations (depression and anxiety) and two conditions with less-developed medical explanations (chronic back pain and fibromyalgia), and how much satisfaction they experienced in treating each condition...
May 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28464182/why-is-reverse-takotsubo-reverse
#13
Daniela Rosu, Sameh Askandar, Rami N Khouzam
OBJECTIVES: Takotsubo cardiomyopathy (TTC) is an acute cardiac syndrome simulating myocardial infarction that is characterized by transient wall motion abnormalities in the absence of coronary artery obstruction. Reverse TTC (rTTC) is a recently described variant of TTC. This review defines and compares both forms of TTC, stating their resemblances and differences. METHODS: We conducted a search of the MEDLINE database. Forty-one cases of rTTC met our eligibility criteria and were summarized in a synthesis of the demographic features, clinical characteristics, and laboratory studies...
May 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28464181/utility-of-hemoccult-testing-before-therapeutic-anticoagulation-in-venous-thromboembolism
#14
Ryan Urbas, Marwan Badri, Nicole E Albert, Catherine Prince, Barani Mayilvaganan
OBJECTIVES: Fecal occult blood testing (FOBT) is performed routinely before starting therapeutic anticoagulation in patients despite it never being validated to predict gastrointestinal bleeding (GIB) risk. Our objective was to determine the utility in checking the guaiac FOBT test (gFOBT) before initiating therapeutic anticoagulation in patients with a new diagnosis of venous thromboembolism (VTE). METHODS: This was a retrospective chart review that examined patients with a diagnosis of VTE admitted during a 2-year period in one mid-sized tertiary care center...
May 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28464180/comorbidity-is-a-competing-factor-for-disease-recurrence-postnephrectomy
#15
Lael Reinstatler, Zachary Klaassen, Rabii Madi, Martha K Terris, Kelvin A Moses
OBJECTIVE: There is a relation between tumor stage and grade with the risk of cancer recurrence in patients undergoing surgical treatment for kidney cancer. The association of patient comorbidity with disease recurrence is less well characterized. The objective of this study was to explore the association between comorbidity and the recurrence of kidney cancer. METHODS: We performed a retrospective analysis of 263 patients who received a partial or radical nephrectomy from January 1, 2000 through April 30, 2013...
May 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28464179/physician-order-entry-clerical-support-improves-physician-satisfaction-and-productivity
#16
Erin Contratto, Katherine Romp, Carlos A Estrada, April Agne, Lisa L Willett
OBJECTIVES: To examine the impact of clerical support personnel for physician order entry on physician satisfaction, productivity, timeliness with electronic health record (EHR) documentation, and physician attitudes. METHODS: All seven part-time physicians at an academic general internal medicine practice were included in this quasi-experimental (single group, pre- and postintervention) mixed-methods study. One full-time clerical support staff member was trained and hired to enter physician orders in the EHR and conduct previsit planning...
May 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28464178/standardized-physician-administered-patient-centered-discharge-protocol-improves-patients-comprehension
#17
Jennifer W Caceres, Scott M Alter, Richard D Shih, Jimmy D Fernandez, Frederick K Williams, Richard Paley, William Benda, Lisa M Clayton
OBJECTIVES: Patients are 30% less likely to be readmitted or visit the emergency department if they have a clear understanding of their discharge instructions. A standardized approach to a hospital discharge plan has not been universally implemented, however. Our goal was to increase patients' comprehension of discharge instructions by implementing a standardized patient-centered discharge planning protocol that uses a physician team member to explain these plans. METHODS: This was a prospective study that included all of the patients discharged from an inpatient medical teaching service in a community-based hospital during the study period...
May 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28464177/hospital-readmissions-from-patients-perspectives
#18
Beril Cakir, Stephanie Kaltsounis, Katherine D' Jernes, Sara Kopf, Julea Steiner
OBJECTIVES: Healthcare expenditures in the United States have increased exponentially and hospital care accounts for one-third of these costs. Approximately 18% of hospitalized Medicare beneficiaries are being readmitted to the hospital within 30 days. Engaging patients in the discharge process can help better identify patients' postdischarge needs and implement more effective readmission prevention strategies. The objective of our study was to identify the factors that contribute to hospital readmission as seen from patients' perspectives in a large urban community hospital...
May 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28464176/breast-feeding-leptin-adiponectin-ratio-and-metabolic-dysfunction-in-adolescents-with-obesity
#19
Nicole L Mihalopoulos, Brittney M Urban, Julie M Metos, Alfred H Balch, Paul C Young, Kristine C Jordan
OBJECTIVES: Increased adiposity increases leptin and decreases adiponectin concentrations, resulting in an increased leptin:adiponectin ratio (LAR). In adults, components of the metabolic syndrome and other cardiometabolic risk factors, what we classify here as "metabolic dysfunction," are associated with both a high LAR and a history of being breast-fed. The relation among breast-feeding, LAR, and degree of metabolic dysfunction in obese youth is unknown. The purpose of our pilot study was to explore this relation and estimate the effect size of the relations to determine the sample size needed to power future prospective studies...
May 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28464175/risky-teen-driving-in-a-rural-southern-state
#20
Kathy Monroe, William Hardwick, Victoria Lawson, Elizabeth Nichols, Michele Nichols, William D King
OBJECTIVE: Alabama is one of the five US states with the highest teen driving mortality. We recruited teen drivers to participate in a questionnaire regarding high-risk driving behaviors. METHODS: Teens were recruited from a large county school system to participate in a voluntary anonymous survey. Questions were taken in part from the National Youth Risk Behavior Survey. Descriptive statistics and odds ratios with 95% confidence intervals were calculated. RESULTS: A total of 1023 teen drivers participated (46% boys, 47% African American, 39% white, 6% Latino, and 7% other)...
May 2017: Southern Medical Journal
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