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Southern Medical Journal

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https://www.readbyqxmd.com/read/29767224/innovative-technique-for-endoscopic-placement-of-sengstaken-blakemore-tube
#1
Arleen M Ortiz, Cesar J Garcia, Mohamed O Othman, Marc J Zuckerman
OBJECTIVES: The Sengstaken-Blakemore (SB) tube is used in cases of uncontrolled variceal bleeding. Because of the complexity of the procedure and the lack of visualization, various techniques have been described to avoid blind placement. We report an innovative and simple technique for placement of the SB tube under direct endoscopic visualization. METHODS: A grasp-and-place technique for endoscopic placement of SB tubes is described and a retrospective cohort study chart review of endoscopies done for variceal bleeding in our medical center is reported...
May 2018: Southern Medical Journal
https://www.readbyqxmd.com/read/29767223/evaluation-of-renal-function-estimation-formulas-specific-to-dynamic-renal-function-for-drug-dosing-in-critically-ill-patients
#2
Lianjie Xiong, Z Kevin Lu, April Miller Quidley, Bebbyn S Alford, P Brandon Bookstaver
OBJECTIVES: The study compared estimated creatinine clearance (eCrCl) between the Cockcroft-Gault (CG) equation and the Jelliffe, Chiou, and Brater equations designed for estimation in dynamic renal function and resulting antimicrobial dosing concordance of five antimicrobials (cefepime, meropenem, piperacillin/tazobactam, vancomycin, and fluconazole) commonly used in the intensive care unit (ICU). METHODS: Electronic medical records were used to identify the target patient population...
May 2018: Southern Medical Journal
https://www.readbyqxmd.com/read/29767222/mortality-in-asthma-chronic-obstructive-pulmonary-disease-overlap-in-the-united-states
#3
Suchit Kumbhare, Charlie Strange
OBJECTIVES: Asthma-chronic obstructive pulmonary disease (COPD) overlap (ACO) is recognized increasingly as a distinct clinical entity and is associated with higher comorbidities compared with patients with asthma and COPD alone. Little is known about the leading causes of death related to ACO in the US general population, however. Our aim was to define the causes of mortality among patients with ACO compared with asthma and COPD in the US population. METHODS: We examined questions using the National Health and Nutrition Examination Survey III database linked to the National Death Index...
May 2018: Southern Medical Journal
https://www.readbyqxmd.com/read/29767221/minimal-use-of-opioids-for-pain-relief-in-an-internal-medicine-department
#4
Zvi Shimoni, Danielle Varon, Paul Froom
OBJECTIVES: The objective of the study was to determine if pain control was adequate despite our policy of limited opioid use. METHODS: In this observational cohort study, we reviewed 300 consecutive patient charts from an internal medicine department. We extracted demographic data, as well as the patients' primary diagnosis, pain on admission, daily pain evaluations (numerical rating score [NRS]), and treatment. Significant pain was defined as a score of ≥3 on the NRS...
May 2018: Southern Medical Journal
https://www.readbyqxmd.com/read/29767220/patients-perceptions-of-bedside-rounding
#5
Allen F Shih, Nana O Addo-Tabiri, Andre N Sofair
OBJECTIVES: Concerns regarding lack of privacy, poor patient understanding, and physician discomfort have led to a decline in rounding at the bedside. Our project explored patient perceptions of the implementation and value of bedside rounding. METHODS: This mixed-methods study used semi-structured qualitative interviews and a five-item Likert survey, which included questions about patients' experiences with rounds, their comfort level with the rounding process, and their understanding of care after rounds...
May 2018: Southern Medical Journal
https://www.readbyqxmd.com/read/29767219/alabama-children-s-body-mass-index-nutritional-attitudes-and-food-consumption-an-exploratory-analysis
#6
Vaughn Millner, Ryon C McDermott, Bernard H Eichold
OBJECTIVES: This study had three aims: assess the extent to which middle school children in southern Alabama were classified as overweight or obese; determine the magnitude of the relation between children's attitudes toward healthy eating and their actual dietary choices; and examine the role of race, sex, and ZIP codes on children's eating attitudes and behaviors. METHODS: Registered dietitians took height and weight measurements of middle school children in southern Alabama to establish body mass index (BMI)...
May 2018: Southern Medical Journal
https://www.readbyqxmd.com/read/29767218/management-of-emotionally-challenging-responses-of-hospitalized-patients-with-cancer
#7
Yelena Burklin, Daniel P Hunt
Cancer is the second leading cause of death in the United States, and the majority of hospital admissions of patients with cancer occur because of uncontrolled, urgent symptoms. In addition to complex physical presentations, these patients often manifest a number of complex emotional and psychological responses resulting in a unique set of healthcare needs and expectations. Inpatient generalists or hospitalists frequently serve as the primary providers of medical care for these patients. Formal training for nononcologists on effective communication strategies in managing patients with cancer in a hospital setting may not fully prepare generalists for challenging patient encounters, however...
May 2018: Southern Medical Journal
https://www.readbyqxmd.com/read/29767217/assessing-mentorship-experiences-of-faculty-at-a-military-academic-center-challenge-and-opportunity
#8
Kevin C McMains, Rechell G Rodriguez, Jennifer Peel, Heather C Yun, Mark W True, Woodson S Jones
OBJECTIVES: Mentor relationships are a key component of professional development within academic medicine. To date, there are no investigations into the prevalence and effects of mentor relationships within military academic medicine. This quality improvement initiative aimed to establish the prevalence and effects of mentorship, including whether sex differences exist among faculty at a military academic center, the San Antonio Uniformed Services Health Education Consortium, and identify opportunities to improve faculty development efforts for mentorship to benefit faculty at this institution...
May 2018: Southern Medical Journal
https://www.readbyqxmd.com/read/29767216/commentary-on-and-now-please-sign-on-the-dotted-line-teaching-residents-about-professional-life-after-residency
#9
Lewis L Hsu, Shivi Jain
No abstract text is available yet for this article.
May 2018: Southern Medical Journal
https://www.readbyqxmd.com/read/29767215/and-now-please-sign-on-the-dotted-line-teaching-residents-about-professional-life-after-residency
#10
Sherine Salib, Victoria Valencia, Alejandro Moreno
OBJECTIVES: Despite possible long-term repercussions, few training programs teach their residents about the business of medicine. In particular, certain contractual issues can adversely affect a young physician's career mobility. METHODS: We designed a business-of-medicine curriculum and used a survey to determine whether the curriculum satisfied attendees' perceived knowledge gaps about the topics covered in the course, which included four key contractual matters: physician employment contracts (including restrictive covenants), malpractice insurance, job search, and interviewing skills...
May 2018: Southern Medical Journal
https://www.readbyqxmd.com/read/29767214/commentary-on-teaching-medical-educators-how-to-teach-communication-skills-more-than-a-decade-of-experience
#11
Patricia G McBurney
No abstract text is available yet for this article.
May 2018: Southern Medical Journal
https://www.readbyqxmd.com/read/29767213/teaching-medical-educators-how-to-teach-communication-skills-more-than-a-decade-of-experience
#12
Carla L Spagnoletti, Sarah Merriam, Laurel Milberg, William I Cohen, Robert M Arnold
OBJECTIVES: Although opportunities exist for medical educators to gain additional training in teaching, literature that describes how to teach educators to teach communication skills to trainees is limited. The authors developed and evaluated a faculty development course that uses didactics, demonstration, drills, and role-play in a small-group format. METHODS: The course has been offered through the Institute for Clinical Research Education at the University of Pittsburgh for almost 15 years...
May 2018: Southern Medical Journal
https://www.readbyqxmd.com/read/29767212/commentary-on-at-the-vatican-physicians-debate-euthanasia-and-assisted-suicide
#13
G Richard Holt
No abstract text is available yet for this article.
May 2018: Southern Medical Journal
https://www.readbyqxmd.com/read/29767211/at-the-vatican-physicians-debate-euthanasia-and-assisted-suicide
#14
Ramin Walter Parsa-Parsi
No abstract text is available yet for this article.
May 2018: Southern Medical Journal
https://www.readbyqxmd.com/read/29719037/provider-variation-in-antibiotic-prescribing-and-outcomes-of-respiratory-tract-infections
#15
Mahesh Manne, Abhishek Deshpande, Bo Hu, Aditi Patel, Glen B Taksler, Anita D Misra-Hebert, Stacey E Jolly, Andrei Brateanu, Robert W Bales, Michael B Rothberg
OBJECTIVES: Inappropriate antibiotic use for respiratory tract infection (RTI) is an ongoing problem linked to the emergence of drug resistance and other adverse effects. Less is known about the prescribing practices of individual physicians or the impact of physician prescribing habits on patient outcomes. We studied the prescribing practices of providers for acute RTIs in an integrated health system, identified patient factors associated with receipt of an antibiotic and assessed the relation between providers' adjusted prescribing rates and a number of patient outcomes...
April 2018: Southern Medical Journal
https://www.readbyqxmd.com/read/29719036/clinical-context-and-detection-of-the-murmur-of-advanced-aortic-stenosis
#16
Ajoe John Kattoor, Anusha Shanbhag, Annette Abraham, Srikanth Vallurupalli
OBJECTIVES: Auscultation is an important clue to the presence of aortic stenosis (AS). We sought to assess the effect of symptom status, prior knowledge of diagnosis, and other patient factors on murmur detection. METHODS: Patients with moderate-to-severe AS by echocardiography at a single center between June 2015 and June 2016 were included. Five consecutive patient encounters (inpatient and outpatient) within 12 months before the echocardiogram were analyzed. RESULTS: Ninety-five patients (418 different clinician encounters) were studied...
April 2018: Southern Medical Journal
https://www.readbyqxmd.com/read/29719035/single-center-retrospective-study-of-risk-factors-and-predictive-value-of-framingham-risk-score-of-patients-with-st-elevation-myocardial-infarction
#17
Sohail Ikram, Ajay Pachika, Henrike Schuster, Aman Ghotra, Laura Dotson, Shoaib Akbar, Abdur Rahman Khan
OBJECTIVES: The objective of this study was to identify risk factors and clinical profile of the patients presenting with ST elevation myocardial infarction (STEMI). We further evaluated the utility of the Framingham Risk Score (FRS) in the accurate identification of these patients if used before their coronary event. METHODS: We evaluated the demographic, clinical, and angiographic characteristics of patients admitted with STEMI. We also calculated cardiovascular event risk using the FRS in a subset of patients without prior known coronary artery disease and diabetes mellitus...
April 2018: Southern Medical Journal
https://www.readbyqxmd.com/read/29719034/measuring-functional-status-in-hospitalized-older-adults-through-electronic-health-record-documentation
#18
Liron Sinvani, Andrzej Kozikowski, Vidhi Patel, Colm Mulvany, Christopher Smilios, Guang Qiu, Meng Zhang, Gisele Wolf-Klein, Renee Pekmezaris
OBJECTIVES: Hospitalization-associated disability affects up to 60% of older adults; however, standardized measures of function are not routinely used and documented. We sought to determine whether nursing documentation in electronic medical records can be used to determine mobility status and associated clinical outcomes. METHODS: A retrospective study of 2383 medical patients aged 75 years and older was conducted at a large academic tertiary hospital in New York...
April 2018: Southern Medical Journal
https://www.readbyqxmd.com/read/29719033/a-social-ecological-review-of-cancer-disparities-in-kentucky
#19
Sharon D Rodriguez, Nathan L Vanderford, Bin Huang, Robin C Vanderpool
Cancer continuously ranks among the top 10 leading causes of death in the United States. The burden of cancer is particularly elevated in the Commonwealth of Kentucky and its 54-county Appalachian region, where cancer is the leading cause of death. Kentucky's high rates of cancer have been attributed to a wide range of socioeconomic, behavioral, environmental, and policy influences, resulting in numerous disparities. The present review specifically evaluates the burden of lung, colorectal, cervical, and head and neck cancers in Kentucky, along with resultant cancer control research and community outreach efforts conducted by the state's only National Cancer Institute-designated cancer center using an adapted version of McLeroy's Social-Ecological Model...
April 2018: Southern Medical Journal
https://www.readbyqxmd.com/read/29719032/commentary-on-importance-of-interdisciplinary-medical-education-a-frontline-perspective
#20
G Richard Holt
No abstract text is available yet for this article.
April 2018: Southern Medical Journal
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