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Southern Medical Journal

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https://www.readbyqxmd.com/read/28771656/transfusion-practice-in-trauma-resuscitation
#1
Ashley M Eckel, John R Hess
Recognition of the acute coagulopathy of trauma and the limits of reconstituting whole blood with conventional blood components has led to a radical change in the way trauma patients with severe injuries are resuscitated. Massive transfusion protocols (MTP) have evolved toward the administration of conventional blood components in fixed ratios. Administration of a 1:1:1 unit ratio of fresh frozen plasma to whole-blood-derived platelets to packed red blood cells is now the most common strategy and the stated goal of directors of >80% of the level I trauma centers in the United States...
August 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28771655/management-of-intrauterine-contraception-in-early-pregnancy
#2
Shanthi S Ramesh, Samantha Charm, Alison Kalinowski, Abigail L Liberty, Gretchen S Stuart
OBJECTIVES: Women with rare intrauterine contraception (IUC) failures are advised to have their IUC removed because of the risk of poor obstetric outcomes with a retained IUC. Specifics regarding IUC removal in early pregnancy including techniques for removal, rates of success, and immediate pregnancy outcomes following removal are not well described, however. The objective of this study was to identify women with an IUC in early pregnancy examined at a tertiary care center with the primary objective of describing IUC removal attempts, IUC removal successes, and pregnancy outcomes at 20 weeks following IUC removal...
August 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28771654/predictors-of-30-day-mortality-in-hospitalized-patients-with-clostridium-difficile-infection
#3
Jayakrishna Chintanaboina, Seyedehsan Navabi, Kristen Suchniak-Mussari, Benjamin Stern, Simranjit Bedi, Erik B Lehman, Andrew Tinsley
OBJECTIVES: Clostridium difficile infection (CDI) is a significant cause of morbidity and mortality and is the most common nosocomial infection in the United States, with associated annual costs of approximately $3 billion. The epidemiology of CDI has changed with the identification of novel risk factors for incident and recurrent CDI. The aim of this study was to identify the predictors of 30-day mortality in hospitalized patients with CDI. METHODS: We identified all of the patients diagnosed as having CDI from January 2011 to December 2014 at our university-setting hospital...
August 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28771653/impact-of-polypharmacy-on-seniors-self-perceived-health-status
#4
Rafia Rasu, Walter Agbor-Bawa, Nahid Rianon
OBJECTIVES: Polypharmacy is common among older patients and is linked to increased risk of adverse health outcomes. This study aimed to explore the association of polypharmacy and self-perceived health status (SPHS) among geriatric patients. METHODS: This cross-sectional analysis of longitudinal observational research used national survey data from 2005-2008. Multivariate logistic regressions examined the likelihood of having a good/poor SPHS and polypharmacy. Medical Expenditure Panel Survey data provided by Agency for Healthcare Research and Quality were used in this study...
August 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28771652/the-premedical-curriculum-we-can-do-better-for-future-physicians
#5
Bharat Kumar, Melissa L Swee, Manish Suneja
No abstract text is available yet for this article.
August 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28771651/bedside-rounds-valued-but-not-preferred-perceptions-of-internal-medicine-residents-and-attending-physicians-in-a-diverse-academic-training-program
#6
Naseema B Merchant, Daniel G Federman
OBJECTIVES: Bedside rounds/rounding (BDR) is an important tool for patient-centered care and trainee education. This study aimed at understanding the attitudes toward BDR among residents and attending physicians. METHODS: A survey was conducted using the Qualtrics survey tool. Responses were measured using a five-point Likert scale. RESULTS: The survey was sent to 301 attending physicians and 195 residents. Attending physicians conducted BDR 19% of the time...
August 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28771650/mitigating-matthew-5-lessons-to-help-improve-hospital-preparedness-in-a-hurricane
#7
Lancer A Scott, Florence E Hutchison
No abstract text is available yet for this article.
August 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28771649/implementing-a-disaster-preparedness-curriculum-for-medical-students
#8
Edward H Jasper, Gregory K Wanner, Dale Berg, Katherine Berg
OBJECTIVES: Training in disaster medicine and preparedness is minimal or absent in the curricula of many medical schools in the United States. Despite a 2003 joint recommendation by the Association of American Medical Colleges and the Centers for Disease Control and Prevention, few medical schools require disaster training for medical students. The challenges of including disaster training in an already rigorous medical school curriculum are significant. We evaluated medical students' experiences with mandatory disaster training during a 2-year period in a medical university setting...
August 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28771648/survey-of-hospital-employees-personal-preparedness-and-willingness-to-work-following-a-disaster
#9
Jane H Brice, David Gregg, Dalton Sawyer, Julianne M Cyr
OBJECTIVES: Little is known about the personal readiness of hospital staff for disasters. As many as 30% of hospital staff say that they plan not to report for work during a large-scale disaster. We sought to understand the personal disaster preparedness for hospital staff. METHODS: Surveys were distributed to the staff of a large academic tertiary-care hospital by either a paper-based version distributed through the departmental safety coordinators or a Web-based version distributed through employee e-mail services, depending on employee familiarity with and access to computer services...
August 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28771647/patients-with-access-and-functional-needs-in-a-disaster
#10
Sharon E Mace, Constance J Doyle
Individuals with special healthcare needs have some of the highest morbidity and mortality rates during disasters. Efforts to triage, transport, shelter, or treat vulnerable populations often fail to take into consideration disabilities and social situations, including caregiver availability. Communication, medical care, independence, supervision, and transportation needs should be considered in emergency preparedness planning. Inconsistencies with the definitions and scope of individuals with special healthcare needs exist...
August 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28771646/assessing-disaster-preparedness-among-select-children-s-summer-camps-in-the-united-states-and-canada
#11
Megan Chang, Alan Sielaff, Stuart Bradin, Kevin Walker, Michael Ambrose, Andrew Hashikawa
OBJECTIVE: Children's summer camps are at risk for multiple pediatric casualties during a disaster. The degree to which summer camps have instituted disaster preparedness is unknown. We assessed disaster preparedness among selected camps nationally for a range of disasters. METHODS: We partnered with a national, web-based electronic health records system to send camp leadership of 315 camp organizations a 14-question online survey of disaster preparedness. One response from each camp was selected in the following order of importance: owner, director, physician, nurse, medical technician, office staff, and other...
August 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28771645/opportunity-for-collaboration-between-radiation-injury-treatment-network-centers-and-medical-toxicology-specialists
#12
Elizabeth Davlantes, Samuel Shartar, Jennifer Venero, Alaina Steck, Amelia Langston, Ziad N Kazzi
OBJECTIVES: The Radiation Injury Treatment Network (RITN) comprises >50 centers across the United States that are poised to care for victims of a radiation emergency. The network is organized around bone marrow transplant centers because these facilities excel in both radiation medicine and the care of patients with severe bone marrow depression. A radiation emergency may cause not only irradiation from an external source but also internal contamination with radioactive material. Because medical toxicologists are trained in radiation injury management and have expertise in the management of internal contamination, RITN centers may benefit from partnerships with medical toxicology resources, which may be located at academic medical centers, hospital inpatient clinical services, outpatient clinics, or poison control centers...
August 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28771644/chester-step-test-as-a-reliable-reproducible-method-of-assessing-physical-fitness-of-disaster-deployment-personnel
#13
Michael S Molloy, Colin M Robertson, Gregory R Ciottone
No abstract text is available yet for this article.
August 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28771643/disaster-medicine-in-the-post-9-11-era
#14
Lancer A Scott
No abstract text is available yet for this article.
August 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28771642/introduction-to-special-series-on-disaster-medicine
#15
G Richard Holt
No abstract text is available yet for this article.
August 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28679019/adequately-addressing-pediatric-obesity-challenges-faced-by-primary-care-providers
#16
Marilou Shreve, Allison Scott, Kelly Vowell Johnson
OBJECTIVE: To assess the challenges primary care providers encounter when providing counseling for pediatric patients identified as obese. METHODS: A survey assessed the current challenges and barriers to the screening and treatment of pediatric obesity for providers in northwest Arkansas who provide care to families. The survey consisted of 15 Likert scale questions and 4 open-ended questions. RESULTS: Time, resources, comfort, and cultural issues were reported by providers as the biggest barriers in screening and the treatment of pediatric obesity...
July 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28679018/underdiagnosis-and-lower-rates-of-office-visits-for-overweight-obese-pediatric-patients-in-rural-compared-with-urban-areas
#17
Christine SanGiovanni, James McElligott, Kristen Morella, William Basco
OBJECTIVES: This study compared the number of children enrolled in Medicaid in rural and urban areas of South Carolina with an overweight/obesity diagnosis and the mean rates of office visits with overweight/obesity diagnosed. METHODS: Medicaid claims data from 2012 for children in three South Carolina counties, categorized as urban, rural high resource, and rural low resource, were used to identify those who had been diagnosed as being overweight/obese during any encounter...
July 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28679017/a-comparison-of-qtc-intervals-in-alcohol-withdrawal-patients-versus-acute-coronary-syndrome-patients
#18
Timothy Chu, Keith Azevedo, Amy A Ernst, Dusadee Sarangarm, Steven J Weiss
OBJECTIVES: Patients with an alcohol use disorder experiencing acute intoxication or withdrawal may be at risk for electrocardiograph (ECG) abnormalities, including prolongation of repolarization (long QTc [corrected QT]) that may contribute to arrhythmias and may be associated with a threefold increase in the likelihood of sudden cardiac events. Patients with acute coronary syndrome may have prolonged QTc as well. To our knowledge, no previous studies have compared the QTc of ACS with acute ethanol (EtOH) withdrawal syndromes in the emergency department (ED)...
July 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28679016/stroke-hospital-characteristics-in-the-florida-puerto-rico-collaboration-to-reduce-stroke-disparities-study
#19
Maria A Ciliberti-Vargas, Hannah Gardener, Kefeng Wang, Chuanhui Dong, Li Yi, Jose G Romano, Mary Robichaux, Salina P Waddy, Ulises Nobo, Sandra Diaz-Acosta, Tatjana Rundek, Michael F Waters, Ralph L Sacco
OBJECTIVES: Although disparities in stroke care and outcomes have been well documented nationally, state-based registries to monitor acute stroke care in Florida (FL) and Puerto Rico (PR) have not been established. The FL-PR Collaboration to Reduce Stroke Disparities (CReSD) was developed to evaluate race-ethnicity and regional disparities in stroke care performance. The objective of this study was to assess and compare hospital characteristics within a large quality improvement registry to identify characteristics associated with better outcomes for acute ischemic stroke care...
July 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28679015/association-between-weight-change-health-outcomes-and-mortality-in-older-residents-in-long-term-care
#20
Wei Zhou, Andrzej Kozikowski, Renee Pekmezaris, James Lolis, Barbara Tommasulo, Joanna Fishbein, Gisele Wolf-Klein
OBJECTIVES: Despite the numerous health risks associated with being overweight, the effect of weight loss on health and longevity remains controversial, particularly in older adults. We explored the association among weight changes, health outcomes, and mortality in older residents of a skilled nursing facility. METHODS: A 6-year retrospective chart review of residents of a long-term care facility was conducted, collecting monthly weights in addition to the clinical and demographic data of all residents for at least 1 year...
July 2017: Southern Medical Journal
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