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https://www.readbyqxmd.com/read/28439351/residents-exposure-to-educational-experiences-in-facilitating-hospital-discharges
#1
Eric Young, Chad Stickrath, Monica McNulty, Aaron J Calderon, Elizabeth Chapman, Jed D Gonzalo, Ethan F Kuperman, Max Lopez, Christopher J Smith, Joseph R Sweigart, Cecelia N Theobald, Robert E Burke
BACKGROUND: There is an incomplete understanding of the most effective approaches for motivating residents to adopt guideline-recommended practices for hospital discharges. OBJECTIVE: We evaluated internal medicine (IM) residents' exposure to educational experiences focused on facilitating hospital discharges and compared those experiences based on correlations with residents' perceived responsibility for safely transitioning patients from the hospital. METHODS: A cross-sectional, multi-center survey of IM residents at 9 US university- and community-based training programs in 2014-2015 measured exposure to 8 transitional care experiences, their perceived impact on care transitions attitudes, and the correlation between experiences and residents' perceptions of postdischarge responsibility...
April 2017: Journal of Graduate Medical Education
https://www.readbyqxmd.com/read/28427233/assessment-of-the-interlaboratory-variability-and-robustness-of-jak2v617f-mutation-assays-a-study-involving-a-consortium-of-19-italian-laboratories
#2
Margherita Perricone, Francesca Palandri, Emanuela Ottaviani, Mario Angelini, Laura Bagli, Enrica Bellesia, Meris Donati, Donato Gemmati, Patrizia Zucchini, Stefania Mancini, Valentina Marchica, Serena Trubini, Giovanna De Matteis, Silvia Di Zacomo, Mosè Favarato, Annamaria Fioroni, Caterina Bolzonella, Giorgia Maccari, Filippo Navaglia, Daniela Gatti, Luisa Toffolatti, Linda Orlandi, Vèronique Laloux, Marco Manfrini, Piero Galieni, Barbara Giannini, Alessia Tieghi, Sara Barulli, Maria Luisa Serino, Monica Maccaferri, Anna Rita Scortechini, Nicola Giuliani, Daniele Vallisa, Massimiliano Bonifacio, Patrizia Accorsi, Cristina Salbe, Vinicio Fazio, Milena Gusella, Eleonora Toffoletti, Marzia Salvucci, Mirija Svaldi, Filippo Gherlinzoni, Francesca Cassavia, Francesco Orsini, Giovanni Martinelli
To date, a plenty of techniques for the detection of JAK2V617F is used over different laboratories, with substantial differences in specificity and sensitivity. Therefore, to provide reliable and comparable results, the standardization of molecular techniques is mandatory.A network of 19 centers was established to 1) evaluate the inter- and intra-laboratory variability in JAK2V617F quantification, 2) identify the most robust assay for the standardization of the molecular test and 3) allow consistent interpretation of individual patient analysis results...
March 6, 2017: Oncotarget
https://www.readbyqxmd.com/read/28410247/ce-original-research-creating-an-evidence-based-progression-for-clinical-advancement-programs
#3
Kathleen G Burke, Tonya Johnson, Christine Sites, Jane Barnsteiner
Findings on the developmental progression of eight nursing competencies and related knowledge, skill, and attitudes. ABSTRACT: Background: The Institute of Medicine (IOM) and the Quality and Safety Education for Nurses (QSEN) project have identified six nursing competencies and supported their integration into undergraduate and graduate nursing curricula nationwide. But integration of those competencies into clinical practice has been limited, and evidence for the progression of competency proficiency within clinical advancement programs is scant...
April 13, 2017: American Journal of Nursing
https://www.readbyqxmd.com/read/28401616/searching-for-staircases-strengthening-the-connections-between-the-emergency-department-and-the-intensive-care-unit
#4
James M Walter, James J Walter
On a fall day in Chicago, a middle-aged man stepped out of a northbound train, appeared to choke, and collapsed. Paramedics arrived within minutes and administered several rounds of defibrillation and intravenous epinephrine. The patient was rapidly transported to an academic medical center, resuscitated in the Emergency Department (ED), and was soon surrounded by a multidisciplinary team of doctors, nurses, and respiratory therapists in the Intensive Care Unit (ICU). This article is protected by copyright...
April 12, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28399727/sharing-difficult-experiences-helps-everyone-to-cope-with-challenges
#5
(no author information available yet)
A study into the effectiveness of Schwartz Center Rounds on healthcare staff has revealed that the programme could increase empathy for patients and improve teamwork and communication.
April 12, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28396900/multidisciplinary-team-approach-to-traumatic-spinal-cord-injuries-a-single-institution-s-quality-improvement-project
#6
Georgina Alizo, Jason D Sciarretta, Stefanie Gibson, Keely Muertos, Sharon Holmes, Felicia Denittis, Joseph Cheatle, John Davis, Antonio Pepe
BACKGROUND: A stepwise multidisciplinary team (MDT) approach to the injured trauma patient has been reported to have an overall benefit, with reduction in mortality and improved morbidity. Based on clinical experience, we hypothesized that implementation of a dedicated Spinal Cord Injury Service (SCIS) would impact outcomes of a patient specific population on the trauma service. METHODS: The trauma center registry was retrospectively queried, from January 2011 through December 2015, for patients presenting with a spinal cord injury...
April 10, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28384742/how-would-you-manage-opioid-use-in-these-three-patients-grand-rounds-discussion-from-beth-israel-deaconess-medical-center
#7
Daniel P Alford, Marc L Cohen, Eileen E Reynolds
The increase in overdose deaths from prescription opioids and heroin in the United States over the past 20 years is believed to have resulted from increases in prescription of opioids for management of acute and chronic pain. Managing chronic pain is challenging for primary care clinicians for many reasons, including the lack of evidence to guide practice. The Centers for Disease Control and Prevention published a comprehensive guideline in 2016 to help clinicians with opioid prescribing for chronic pain. In this Grand Rounds, the guideline is reviewed and an expert discusses its application to 3 patients prescribed opioids to treat chronic pain...
April 4, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28351785/british-lung-foundation-united-kingdom-primary-immunodeficiency-network-consensus-statement-on-the-definition-diagnosis-and-management-of-granulomatous-lymphocytic-interstitial-lung-disease-in-common-variable-immunodeficiency-disorders
#8
REVIEW
John R Hurst, Nisha Verma, David Lowe, Helen E Baxendale, Stephen Jolles, Peter Kelleher, Hilary J Longhurst, Smita Y Patel, Elisabetta A Renzoni, Clare R Sander, Gerard R Avery, Judith L Babar, Matthew S Buckland, Siobhan Burns, William Egner, Mark M Gompels, Pavels Gordins, Jamanda A Haddock, Simon P Hart, Grant R Hayman, Richard Herriot, Rachel K Hoyles, Aarnoud P Huissoon, Joseph Jacob, Andrew G Nicholson, Doris M Rassl, Ravishankar B Sargur, Sinisa Savic, Suranjith L Seneviratne, Michael Sheaff, Prashantha M Vaitla, Gareth I Walters, Joanna L Whitehouse, Penny A Wright, Alison M Condliffe
A proportion of people living with common variable immunodeficiency disorders develop granulomatous-lymphocytic interstitial lung disease (GLILD). We aimed to develop a consensus statement on the definition, diagnosis, and management of GLILD. All UK specialist centers were contacted and relevant physicians were invited to take part in a 3-round online Delphi process. Responses were graded as Strongly Agree, Tend to Agree, Neither Agree nor Disagree, Tend to Disagree, and Strongly Disagree, scored +1, +0...
March 25, 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/28351066/bringing-rounds-back-to-the-patient-a-one-year-evaluation-of-the-chiefs-service-model-for-inpatient-teaching
#9
Nadia L Bennett, Judd D Flesch, Peter Cronholm, James B Reilly, Jack Ende
PURPOSE: The Chiefs' Service (CS), a structured approach to inpatient teaching rounds, focuses on resident education and patient-centered care without disrupting patient census sizes or admitting cycles. It has five key elements: morning huddles; bedside rounds; diagnostic "time-outs"; day-of-discharge rounds; and postdischarge follow-up rounds. The authors hypothesized the CS model would be well received by residents and considered more effective than more-traditional rounds. METHOD: The CS was implemented on Penn Presbyterian Medical Center's general medicine inpatient service using a quasi-experimental design...
April 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28330737/optimizing-the-assessment-of-pediatric-injury-severity-in-low-resource-settings-consensus-generation-through-a-modified-delphi-analysis
#10
Etienne St-Louis, Dan Leon Deckelbaum, Robert Baird, Tarek Razek
INTRODUCTION: Although a plethora of pediatric injury severity scoring systems is available, many of them present important challenges and limitations in the low resource setting. Our aim is to generate consensus among a group of experts regarding the optimal parameters, outcomes, and methods of estimating injury severity for pediatric trauma patients in low resource settings. MATERIALS AND METHODS: A systematic review of the literature was conducted to identify and compare existing injury scores used in pediatric patients...
March 15, 2017: Injury
https://www.readbyqxmd.com/read/28329521/a-rare-case-of-cutaneous-acanthamoebiasis-in-a-renal-transplant-patient
#11
Frank Winsett, Jessica Dietert, Jaime Tschen, Michael Swaby, Carolyn A Bangert
A 35-year-old woman receiving immunosuppressionfor renal transplantation presented with a onemonthhistory of tender skin nodules on herbilateral upper extremities. A skin biopsy revealedgranulomatous inflammation in the deep dermisand the subcutaneous fat with foci of necrosis.Within the foci of necrosis were large histiocytoidstructures with prominent nuclei. Periodic acid-Schiffstain revealed a round organism with a thick capsule,consistent with amoebal trophozoites. Testing withthe Center for Disease Control revealed the organismto be Acanthamoeba...
March 15, 2017: Dermatology Online Journal
https://www.readbyqxmd.com/read/28325766/staphylococcal-%C3%AE-toxin-modulates-human-aortic-endothelial-cell-and-platelet-function-through-sphingomyelinase-and-biofilm-ligase-activities
#12
Alfa Herrera, Katarina Kulhankova, Vijay K Sonkar, Sanjana Dayal, Aloysius J Klingelhutz, Wilmara Salgado-Pabón, Patrick M Schlievert
Staphylococcus aureus causes many infections, such as skin and soft tissue, pneumonia, osteomyelitis, and infective endocarditis (IE). IE is an endovascular infection of native and prosthetic valves and the lining of the heart; it is characterized by the formation of cauliflower-like "vegetations" composed of fibrin, platelets, other host factors, bacteria, and bacterial products. β-Toxin is an S. aureus virulence factor that contributes to the microorganism's ability to cause IE. This cytolysin has two enzymatic activities: sphingomyelinase (SMase) and biofilm ligase...
March 21, 2017: MBio
https://www.readbyqxmd.com/read/28316317/direct-two-minute-unassisted-breathing-evaluation-dtube-is-an-attractive-alternative-to-longer-spontaneous-breathing-trials-a-prospective-observational-study
#13
Matthew B Bloom, Jonathan Lu, Tri Tran, Marko Bukur, Rex Chung, Eric J Ley, Nicolas Melo, Ali Salim, Daniel R Margulies
We sought to identify a simple bedside method to predict successful extubation outcomes that might be used during rounds. We hypothesized that a direct 2-minute unassisted breathing evaluation (DTUBE) could replace a longer spontaneous breathing trial (SBT). Data were prospectively collected on all patients endotracheally intubated for >48 hours nearing extubation in a tertiary center's mixed trauma/surgical intensive care unit from August 2012 to August 2013. The SBT was performed for at least 30 minutes at 40 per cent FiO2, PEEP 5, and PS 8...
March 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28301412/large-silicone-droplets-after-intravitreal-bevacizumab-avastin
#14
Robert L Avery, Alessandro A Castellarin, Dilsher S Dhoot, Dante J Pieramici, Maʼan A Nasir, Nathan C Steinle, Logan P Avery, Gabriel M Gordon
PURPOSE: Despite its off-label status, intravitreal bevacizumab is the most commonly used intraocular anti-vascular endothelial growth factor agent. Regulation of compounding pharmacies has recently increased to make compounded pharmaceuticals safer. Despite these changes, a marked increase in symptomatic, large silicone oil droplets following intravitreal bevacizumab injections was noticed. METHODS: Retrospective chart review was performed. Within a single private practice, patients who were noted to have large or symptomatic silicone oil bubbles after an intravitreal injection were reviewed...
March 15, 2017: Retinal Cases & Brief Reports
https://www.readbyqxmd.com/read/28300853/the-international-dermatology-outcome-measures-ideom-initiative-a-review-and-update
#15
Scott A Elman, Joseph F Merola, April W Armstrong, Kristina Callis Duffin, John Latella, Amit Garg, Alice B Gottlieb
<p>The International Dermatology Outcome Measures (IDEOM) group, comprising patients, physicians, health economists, industry partners, payers, and regulatory agencies, was established to develop unified and validated patient-centered outcome measures in dermatology in response to increasing demand to quantify effectiveness of treatments and performance outcomes among providers. IDEOM has chosen to start with psoriasis outcome measures, and then apply its methodology to other dermatologic diseases. In this paper, we review the background and progress to date of IDEOM, including an update of IDEOM activities as of our 2016 meeting in Washington DC, USA...
February 1, 2017: Journal of Drugs in Dermatology: JDD
https://www.readbyqxmd.com/read/28295964/respiratory-virus-infection-after-allogeneic-hematopoietic-stem-cell-transplant-in-a-tropical-center-predictive-value-of-the-immunodeficiency-scoring-index
#16
Lin Wang, John Allen, Colin Diong, Yeow-Tee Goh, Sathish Gopalakrishnan, Aloysius Ho, William Hwang, Francesca Lim, Lynette Oon, Thuan-Tong Tan, Yeh-Ching Linn, Ban-Hock Tan
BACKGROUND: Respiratory virus infection (RVI) is a prevalent infection in patients after allogeneic hematopoietic stem cell transplant (allo-HSCT) and can result in significant morbidity and mortality. Ability to assess the potential severity of RVI is important in the management of such patients. METHODS: We reviewed the cases of RVI in allo-HSCT recipients and explored the predictive value of the immunodeficiency scoring index (ISI) established for respiratory syncytial virus (RSV) and its applicability for RVI caused by other respiratory viruses...
March 10, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28292304/design-and-implementation-of-electronic-health-record-integrated-clinical-prediction-rules-icpr-a-randomized-trial-in-diverse-primary-care-settings
#17
David A Feldstein, Rachel Hess, Thomas McGinn, Rebecca G Mishuris, Lauren McCullagh, Paul D Smith, Michael Flynn, Joseph Palmisano, Gheorghe Doros, Devin Mann
BACKGROUND: Clinical prediction rules (CPRs) represent a method of determining individual patient risk to help providers make more accurate decisions at the point of care. Well-validated CPRs are underutilized but may decrease antibiotic overuse for acute respiratory infections. The integrated clinical prediction rules (iCPR) study builds on a previous single clinic study to integrate two CPRs into the electronic health record and assess their impact on practice. This article discusses study design and implementation of a multicenter cluster randomized control trial of the iCPR clinical decision support system, including the tool adaptation, usability testing, staff training, and implementation study to disseminate iCPR at multiple clinical sites across two health care systems...
March 14, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28288172/the-impact-of-an-intervention-to-introduce-malaria-rapid-diagnostic-tests-on-fever-case-management-in-a-high-transmission-setting-in-uganda-a-mixed-methods-cluster-randomized-trial-prime
#18
Clare I R Chandler, Emily L Webb, Catherine Maiteki-Sebuguzi, Susan Nayiga, Christine Nabirye, Deborah D DiLiberto, Emmanuel Ssemmondo, Grant Dorsey, Moses R Kamya, Sarah G Staedke
BACKGROUND: Rapid diagnostic tests for malaria (mRDTs) have been scaled-up widely across Africa. The PRIME study evaluated an intervention aiming to improve fever case management using mRDTs at public health centers in Uganda. METHODS: A cluster-randomized trial was conducted from 2010-13 in Tororo, a high malaria transmission setting. Twenty public health centers were randomized in a 1:1 ratio to intervention or control. The intervention included training in health center management, fever case management with mRDTs, and patient-centered services; plus provision of mRDTs and artemether-lumefantrine (AL) when stocks ran low...
2017: PloS One
https://www.readbyqxmd.com/read/28287940/diagnosis-and-management-of-complications-from-percutaneous-biliary-tract-interventions
#19
Nanda Venkatanarasimha, Karthik Damodharan, Apoorva Gogna, Sum Leong, Chow Wei Too, Ankur Patel, Kiang Hiong Tay, Bien Soo Tan, Richard Lo, Farah Irani
Complications related to percutaneous biliary tract interventions (PBTIs) can range from access site discomfort to life-threatening vascular complications. These complications are relatively uncommon, and most of them are self-limiting. However, major complications for which an increased level of patient care and/or a prolonged hospital stay are required and that may lead to death-albeit rarely-can occur. Some of the most common complications related to PBTI include pain, infection, bile leakage, and catheter blockage...
March 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/28287827/intensive-care-unit-educators-a-multicenter-evaluation-of-behaviors-residents-value-in-attending-physicians
#20
Lekshmi Santhosh, Snigdha Jain, Anna Brady, Michelle Sharp, W Graham Carlos
RATIONALE: It is important for attending physicians to know which behaviors influence learner perceptions. To date, two studies focusing on general medicine attending physicians have been published addressing internal medicine residents' perceptions of attending physicians; there are no data on intensive care unit (ICU) attending physicians. OBJECTIVES: We sought to expand the evidence regarding this topic through a multicenter study at four geographically diverse academic medical centers...
April 2017: Annals of the American Thoracic Society
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