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Physician Performance reviews

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https://www.readbyqxmd.com/read/28107122/evaluating-the-impact-of-pharmacists-on-reducing-use-of-sedative-hypnotics-for-treatment-of-insomnia-in-long-term-care-facility-residents
#1
Maria Grazia Gemelli, Katherine Yockel, Kenneth C Hohmeier
OBJECTIVE: To determine if pharmacist intervention can decrease the use of inappropriate sedative/hypnotics in the elderly population in the long-term care facility setting. DESIGN: A multicenter, prospective chart review of sedative/hypnotic use for insomnia among long-term care facility residents. SETTING: Eleven regional long-term care facilities in Northeastern Tennessee. PARTICIPANTS: Long-term care facility residents older than 65 years of age, with confirmed insomnia diagnoses and no history of seizure or recent psychotropic gradual-dose reduction attempts...
November 1, 2016: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/28106498/performing-concurrent-operations-in-academic-vascular-neurosurgery-does-not-affect-patient-outcomes
#2
Corinna C Zygourakis, Janelle Lee, Julio Barba, Errol Lobo, Michael T Lawton
OBJECTIVE Concurrent surgeries, also known as "running two rooms" or simultaneous/overlapping operations, have recently come under intense scrutiny. The goal of this study was to evaluate the operative time and outcomes of concurrent versus nonconcurrent vascular neurosurgical procedures. METHODS The authors retrospectively reviewed 1219 procedures performed by 1 vascular neurosurgeon from 2012 to 2015 at the University of California, San Francisco. Data were collected on patient age, sex, severity of illness, risk of mortality, American Society of Anesthesiologists (ASA) status, procedure type, admission type, insurance, transfer source, procedure time, presence of resident or fellow in operating room (OR), number of co-surgeons, estimated blood loss (EBL), concurrent vs nonconcurrent case, severe sepsis, acute respiratory failure, postoperative stroke causing neurological deficit, unplanned return to OR, 30-day mortality, and 30-day unplanned readmission...
January 20, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28104362/use-of-management-pathways-or-algorithms-in-children-with-chronic-cough-chest-guideline-and-expert-panel-report
#3
Anne B Chang, John J Oppenheimer, Miles M Weinberger, Bruce K Rubin, Kelly Weir, Cameron C Grant, Richard S Irwin
BACKGROUND: Using management algorithms or pathways potentially improves clinical outcomes. We undertook systematic reviews to examine various aspects in the generic approach (use of cough algorithms and tests) to the management of chronic cough in children (aged ≤14-years) based on key questions using the PICO format. METHODS: We used the CHEST expert cough panel's protocol for the systematic reviews and the American College of Chest Physicians (CHEST) methodological guidelines and GRADE framework...
January 16, 2017: Chest
https://www.readbyqxmd.com/read/28104044/procedural-variations-in-performing-primary-percutaneous-coronary-intervention-in-patients-with-st-elevation-myocardial-infarction
#4
Radhika M Mehta, Manyoo Agarwal, Ikechukwu Ifedili, Wael W Rizk, Rami N Khouzam
Multiple variations exist in performing a primary percutaneous coronary intervention (pPCI) in ST-segment elevation myocardial infarction (STEMI) among various cardiologists. These variations range from the choice of peripheral access artery (radial vs femoral), performance or time of complete angiography including left ventriculography, and nonculprit vessel angiography before or after intervening on the culprit vessel. The reasons for such variations include emphasis on door-to-balloon time, knowledge of cardiac anatomy before proceeding with pPCI, physician expertise, and the level of comfort with radial approach...
February 2017: Current Problems in Cardiology
https://www.readbyqxmd.com/read/28102467/mypod-an-emr-based-tool-that-facilitates-quality-improvement-and-maintenance-of-certification
#5
Loren Berman, Brian Duffy, B Randall Brenn, Charles Vinocur
Maintenance of Certification (MOC) was designed to assess physician competencies including operative case volume and outcomes. This information, if collected consistently and systematically, can be used to facilitate quality improvement. Information automatically extracted from the electronic medical record (EMR) can be used as a prompt to compile these data. We developed an EMR-based program called MyPOD (My Personal Outcomes Data) to track surgical outcomes at our institution. We compared occurrences reported in the first 18 months to those captured in the American College of Surgeons National Surgical Quality Improvement Program-Pediatric (ACS NSQIP-P) over the same time period...
March 2017: Journal of Medical Systems
https://www.readbyqxmd.com/read/28100857/-clinical-features-and-findings-in-patients-with-unruptured-intracranial-aneurysms-aged-%C3%A2-80-years
#6
Tetsuhiro Kamo, Naoki Akioka, Daina Kashiwazaki, Masaki Koh, Naoya Kuwayama, Satoshi Kuroda
OBJECTIVE: It is difficult to decide whether to treat unruptured intracranial aneurysm(UIA)in elderly patients aged ≥80 years because they have potentially shorter life expectancy and risks related to treatment. Here, we report the results of the treatment of patients aged ≥80 years. METHODS: A retrospective review was performed in patients who underwent surgical or endovascular treatment between April 2012 and December 2015 at our institution. RESULTS: Between April 2012 and December 2015 we treated 130 UIA patients who presented with 145 aneurysms and 12 patients who presented with 14 aneurysms, who were aged ≥80 years...
January 2017: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/28100229/surveillance-of-life-long-antibiotics-a-review-of-antibiotic-prescribing-practices-in-an-australian-healthcare-network
#7
Jillian S Y Lau, Christopher Kiss, Erika Roberts, Kylie Horne, Tony M Korman, Ian Woolley
BACKGROUND: The rise of antimicrobial use in the twentieth century has significantly reduced morbidity due to infection, however it has also brought with it the rise of increasing resistance. Some patients are on prolonged, if not "life-long" course of antibiotics. The reasons for this are varied, and include non-infectious indications. We aimed to study the characteristics of this potential source of antibiotic resistance, by exploring the antibiotic dispensing practices and describing the population of patients on long-term antibiotic therapy...
January 18, 2017: Annals of Clinical Microbiology and Antimicrobials
https://www.readbyqxmd.com/read/28099821/medication-non-adherence-in-adult-patients-affected-by-inflammatory-bowel-disease-a-critical-review-and-update-of-the-determining-factors-consequences-and-possible-interventions
#8
Marco Vincenzo Lenti, Christian P Selinger
Achieving adherence to medications can be a serious challenge for patients affected by inflammatory bowel disease (IBD). Medical treatment is fundamental for inducing and maintaining remission, preventing flares and reducing the risk of colorectal cancer. Non-adherence may affect patients' quality of life resulting in unfavourable treatment outcomes, more hospitalizations and higher healthcare-related costs. Recognising and improving adherence is therefore a primary aim for the treatment of IBD. Areas covered: We critically discuss the current knowledge on medication non-adherence in adult patients affected by IBD, also mentioning a few issues concerning the paediatric and adolescent populations...
January 18, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28098712/business-education-for-plastic-surgeons-a-systematic-review-development-and-implementation-of-a-business-principles-curriculum-in-a-residency-program
#9
Bahar Zarrabi, Karen K Burce, Stella M Seal, Scott D Lifchez, Richard J Redett, Kevin Frick, Amir H Dorafshar, Carisa M Cooney
BACKGROUND: Rising healthcare costs, decreasing reimbursement rates, and changes in American healthcare are forcing physicians to become increasingly business-minded. Both academic and private plastic surgeons can benefit from being educated in business principles. We conducted a systematic review to identify existing business curricula and integrated a business principles curriculum into residency training. METHODS: We anonymously surveyed our department regarding perceived importance of business principles and performed a systematic literature review from 1993-2013 using PubMed and Embase to identify residency training programs that had designed/implemented business curricula...
January 13, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28098585/the-missing-record-of-mental-status-in-written-sign-outs
#10
Michael Croix, Donna Miller, Jeff Whittle, Siddhartha Singh, Marilyn M Schapira, Jennifer Carnahan, Jessica Kuester, Christa Kallio, Susan Framberg, Kathlyn E Fletcher
OBJECTIVE: The aim of the study was to determine how frequently mental status and mental status changes are documented in the written patient summary ("sign-out") provided to covering physicians. PATIENTS AND METHODS: This was a retrospective cohort study of general medical patients hospitalized between March 16, 2009, and March 15, 2010, conducted at 2 teaching hospitals. Participants included patients with mental status change adverse events (MSAEs) and their providers...
January 16, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28098111/incidence-of-hepatitis-c-virus-seroconversion-among-hemodialysis-patients-in-the-nile-delta-of-egypt-a-single-center-study
#11
Amany Talaat Kamal, Mohamed Nazmy Farres, Abeer Mohamed Eissa, Naglaa Ahmed Arafa, Raafat Saad Abdel-Reheem
Egypt has the highest worldwide prevalence of hepatitis C virus (HCV) infection, caused in part by nosocomial transmission. Patients on hemodialysis (HD) are at especially high risk of infection. We aimed to estimate the incidence of seroconversion among HCV-negative patients undergoing regular HD at a unit in a large public hospital in the Nile Delta of Egypt, which implements the Egyptian Ministry of Health guidelines for infection control, and an isolation policy for hepatitis-positive patients. We also assessed the adherence to infection control practices and evaluated nurses and physicians' knowledge and attitude toward infection control procedures...
January 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28097444/obstetric-outcome-of-vanishing-twins-syndrome-a-systematic-review-and-meta-analysis
#12
REVIEW
Ling Sun, Ling X Jiang, Heng Z Chen
PURPOSE: Due to the high number of multiple embryo transfers into the uterus performed in assisted reproductive technology treatment (ART), the incidences of twin pregnancy and of vanishing twin syndrome (VTS) are correspondingly high. A number of studies have described the obstetric outcomes of the remaining fetus produced after the other twin had vanished compared with a singleton at the start following ART, but the results are mixed and contradictory. We performed a systematic review of the existing studies to explore the actual obstetric outcome of VTS to allow physicians to adequately advise their patients...
January 17, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28095788/are-interventions-to-increase-the-uptake-of-screening-for-cardiovascular-disease-risk-factors-effective-a-systematic-review-and-meta-analysis
#13
A T Cheong, S M Liew, E M Khoo, N F Mohd Zaidi, K Chinna
BACKGROUND: Cardiovascular disease (CVD) is the leading cause of death globally. However, many individuals are unaware of their CVD risk factors. The objective of this systematic review is to determine the effectiveness of existing intervention strategies to increase uptake of CVD risk factors screening. METHODS: A systematic search was conducted through Pubmed, CINAHL, EMBASE and Cochrane Central Register of Controlled Trials. Additional articles were located through cross-checking of the references list and bibliography citations of the included studies and previous review papers...
January 17, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28094490/urinary-incontinence-in-women-non-pharmacologic-approaches-and-newer-pharmacotherapies-an-update
#14
Casey G Kowalik, Joshua A Cohn, Alex Gomelsky, Roger R Dmochowski
Urinary incontinence is a widespread problem for women, with stress urinary incontinence (SUI) being the most common type. An updated review of PubMed literature using the following keywords was performed: stress urinary incontinence, women, midurethral slings, bulking agents, pubovaginal slings, retropubic suspension, postoperative complications, and treatment outcome. More recent publications, systematic reviews, and meta-analyses were given preference. The aging population will increase the demand for care of women with SUI...
January 17, 2017: Minerva Medica
https://www.readbyqxmd.com/read/28093372/does-trainee-involvement-in-fluoroscopic-injections-affect-fluoroscopic-time-immediate-pain-reduction-and-complication-rate
#15
Daniel Cushman, Masaru Teramoto, Bradley Curtis, David T Lee, Austin Marcolina, Zachary McCormick
BACKGROUND: Patients have expressed concern about undergoing procedures involving trainees, even with direct attending physician supervision. Little literature examines the effect of trainee involvement on patient outcomes. OBJECTIVE: We aimed to evaluate the effect of trainee involvement on patient complications, immediate pain reduction, and fluoroscopic time for different fluoroscopic injection types. DESIGN: Retrospective review. SETTING: Four academic outpatient institutions with ACGME-accredited residency (PM&R or Anesthesiology) or fellowship (Sports Medicine or Pain Medicine) programs from 2000-2015...
January 13, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/28091866/review-of-diagnostic-challenges-in-occupational-asthma
#16
REVIEW
Jacques A Pralong, Andre Cartier
PURPOSE OF REVIEW: Occupational asthma (OA) is one of the most frequent occupational diseases and its diagnosis is often difficult. This review summarizes its current diagnostic challenges. RECENT FINDINGS: OA is associated with significant health and socio-economic burden. It is underdiagnosed and physicians need to adopt a stepwise approach to confirm the diagnosis. Although early removal from exposure to the offending agent is associated with a better prognosis, physicians should try to confirm the diagnosis of work-related asthma before taking a worker off work...
January 2017: Current Allergy and Asthma Reports
https://www.readbyqxmd.com/read/28089967/clinical-orofacial-examination-in-juvenile-idiopathic-arthritis-international-consensus-based-recommendations-for-monitoring-patients-in-clinical-practice-and-research-studies
#17
Peter Stoustrup, Marinka Twilt, Lynn Spiegel, Kasper Dahl Kristensen, Bernd Koos, Thomas Klit Pedersen, Annelise Küseler, Randy Q Cron, Shelly Abramowicz, Carlalberta Verna, Timo Peltomäki, Per Alstergren, Ross Petty, Sarah Ringold, Sven Erik Nørholt, Rotraud K Saurenmann, Troels Herlin
OBJECTIVE: To develop international consensus-based recommendations for the orofacial examination of patients with juvenile idiopathic arthritis (JIA), for use in clinical practice and research. METHODS: Using a sequential phased approach, a multidisciplinary task force developed and evaluated a set of recommendations for the orofacial examination of patients with JIA. Phase 1: A Delphi survey was conducted among 40 expert physicians and dentists with the aim of identifying and ranking the importance of items for inclusion...
January 15, 2017: Journal of Rheumatology
https://www.readbyqxmd.com/read/28081032/a-systematic-review-of-the-factors-influencing-ethnic-minority-women-s-cervical-cancer-screening-behavior-from-intrapersonal-to-policy-level
#18
Dorothy N S Chan, Winnie K W So
BACKGROUND: Cervical cancer can be prevented by effective screening using Papanicolaou tests, but the utilization rate is lower among ethnic minorities than in the general population. Understanding the factors influencing minorities' use of such screening can aid the design of an appropriate intervention to increase their uptake rate. OBJECTIVE: The aims of this study were to examine the factors that influence ethnic minority women in using cervical cancer screening and the similarities and differences in associated factors across different groups and to explore the interrelationships between the factors identified...
January 9, 2017: Cancer Nursing
https://www.readbyqxmd.com/read/28076003/reducing-functional-mr-imaging-acquisition-times-by-optimizing-workflow
#19
Wilson B Chwang, Michael Iv, Jason Smith, Aleksandrs Kalnins, Jake Mickelsen, Roland Bammer, Dominik Fleischmann, David B Larson, Max Wintermark, Michael Zeineh
Functional magnetic resonance (MR) imaging is a complex, specialized examination that is able to noninvasively measure information critical to patient care such as hemispheric language lateralization ( 1 ). Diagnostic functional MR imaging requires extensive patient interaction as well as the coordinated efforts of the entire health care team. We observed in our practice at an academic center that the times to perform functional MR imaging examinations were excessively lengthy, making scheduling of the examination difficult...
January 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/28075182/dispersing-the-mists-an-experimental-history-of-medicine-study-into-the-quality-of-volatile-inhalations
#20
Barry Murnane, Cathal T Gallagher, Noel Snell, Mark Sanders, Ramin Moshksar, Darragh Murnane
BACKGROUND: Dr. Nelson's Improved Inhaler was first marketed with an advertisement in The Lancet in 1865. Revolutionary at the time for its ease of use and patient-friendliness, the inhaler is still in use for self-treatment by many all over the world. On the occasion of its 150th anniversary, this study reports an experimental historical medicine approach to identify evidence for the quality of vapor inhalers. METHODS: Through accessing reviews of the device's use by the contemporary medical establishment, it was established that Dr...
January 11, 2017: Journal of Aerosol Medicine and Pulmonary Drug Delivery
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