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Patient centered rounds

Alejo Mancebo, María Luisa González-Diéguez, Carmen A Navascués, Valle Cadahía, María Varela, Ramón Pérez, Luis Rodrigo, Manuel Rodríguez
BACKGROUND: Patient adherence to screening for hepatocellular carcinoma (HCC) is not well known. Our aims were to analyze the adherence to a surveillance program in a prospective cohort of cirrhotic patients and to examine its association with HCC stage at diagnosis. MATERIALS AND METHODS: A total of 770 patients with cirrhosis were examined semiannually by ultrasound and alpha-fetoprotein at a tertiary center. We collected data on 17 variables at baseline. Suboptimal adherence was defined as failure to complete 2 consecutive screening rounds...
October 21, 2016: Journal of Clinical Gastroenterology
Donald C Moore, Gary Neal McVey
PURPOSE: To evaluate the potential cost savings incurred from a policy to round doses of bevacizumab to the nearest vial size. Secondarily, to determine differences in rates of adverse events between patients who had their doses rounded up compared with those who had doses rounded down. METHODS: This study is a retrospective chart review of all patients who received at least one rounded dose of bevacizumab over a period of 22 months. Doses of bevacizumab were calculated based on actual body weight...
October 19, 2016: Journal of Oncology Pharmacy Practice
Hamilton C Tsang, Susan Mathew, Cynthia M Magro
Diffuse large cell B-cell lymphoma of the skin is most commonly represented by diffuse large cell variants of primary cutaneous follicle center lymphoma and the leg-type lymphoma. In a minority of cases, the infiltrates are an expression of stage 4 disease of established extracutaneous B-cell lymphoma. We describe 1 female patient 85 years of age with an aggressive form of primary cutaneous B-cell lymphoma manifesting in multiple firm erythematous indurated solid nodules 1-2 cm each symmetrically on the face periorbitally and on the upper extremities bilaterally...
October 18, 2016: American Journal of Dermatopathology
Hong Seok Lee, Jeong Il Yu, Do Hoon Lim, Sung Joo Kim
PURPOSE: To evaluate the benefit of adjuvant radiation therapy (RT) for retroperitoneal liposarcoma (RPLS) following gross tumor removal. MATERIALS AND METHODS: We reviewed 77 patients with primary RPLS surgically treated between January 2000 and December 2013. Cases with gross residual disease were excluded. Tumor grade was evaluated according to the French Federation of Cancer Centers Sarcoma Group (FNCLCC) system. Adjuvant RT was delivered to 32 patients (42%) using external beam RT alone...
September 2016: Radiation Oncology Journal
Peri Kocabayoglu, Martin Husen, Oliver Witzke, Andreas Kribben, Fuat H Saner, Ali Canbay, Guido Gerken, Andreas Paul
BACKGROUND: Morbidity and mortality conferences (MMCs) provide powerful opportunities for learning, reflection, and improvement. The current literature gives examples of how MMCs can be designed; however, no systematic review of cases and no original data related to liver transplantation are available. Liver transplantation requires a multidisciplinary approach to case identification, presentation, and analysis. Framework structures that guide case investigation are needed to successfully follow up on outcome measures and provide the basis for quality assessment and transparency in transplant programs...
August 2016: Visc Med
Dominika Batycka-Stachnik, Agnieszka Piwoda, Tomasz Darocha, Malgorzata Spiewak, Sylweriusz Kosinski, Anna Jarosz, Hubert Hymczak, Tomasz Sanak, Robert Galazkowski, Jacek Piatek, Janusz Konstanty-Kalandyk, Rafal Drwila
: The objectives: To show and discuss the most frequent functional problems encountered in patients who underwent extracorporeal membrane oxygenation (ECMO) treatment after severe hypothermia and point out appropriate physiotherapy procedures used in order to diminish the effects of hypothermia on the human organism. It is necessary to look for effective physiotherapeutic solutions, especially that the number of scientific publications on the subject is very limited. DESIGN: Retrospective analysis Setting: Severe Accidental Hypothermia Center ( medical intensive care unit of a university hospital) Patients or participants: Nineteen patients who were qualified for ECMO in Severe Accidental Hypothermia Center Intervention: At least three times a day rehabilitation session (physiotherapeutic procedures adequate to patient problems) and interventions in case of emergency...
2016: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
Gowri Anandarajah, Janet Roseman, Danny Lee, Nupur Dhandhania
CONTEXT: Although spiritual care (SC) is recognized as important in whole-person medicine, physicians infrequently address patients' spiritual needs, citing lack of training. Although many SC curricula descriptions exist, few studies report effects on physicians. OBJECTIVES: To broadly examine immediate and long-term effects of a required, longitudinal, residency SC curriculum, which emphasized inclusive patient-centered SC, compassion and spiritual self-care. METHODS: We conducted in-depth individual interviews with 26 physicians (13 intervention;13 comparison) trained at a 13-13-13 residency...
October 3, 2016: Journal of Pain and Symptom Management
Kamran Moradi, Atena Rahmati Najarkolai, Fatemeh Keshmiri
: HOW TO OBTAIN CONTACT HOURS BY READING THIS ISSUE Instructions: 1.3 contact hours will be awarded by Villanova University College of Nursing upon successful completion of this activity. A contact hour is a unit of measurement that denotes 60 minutes of an organized learning activity. This is a learner-based activity. Villanova University College of Nursing does not require submission of your answers to the quiz. A contact hour certificate will be awarded after you register, pay the registration fee, and complete the evaluation form online at http://goo...
October 1, 2016: Journal of Continuing Education in Nursing
Gerald W Smetana, Martin J Abrahamson, David M Rind
The prevalence of diabetes in the United States is rising. Twelve percent of U.S. adults have diabetes and another 37% have impaired fasting glucose or impaired glucose tolerance. Diabetes is a major risk factor for such outcomes as cardiovascular disease, blindness, chronic kidney disease, and limb amputation. An important consideration is whether screening for abnormal glucose levels or diabetes reduces cardiovascular or all-cause morbidity and mortality. In October 2015, the U.S. Preventive Services Task Force published recommendations on screening for abnormal blood glucose and concluded that intensive lifestyle interventions have a moderate benefit in reducing progression to diabetes in patients who have abnormal blood glucose levels detected by screening...
October 4, 2016: Annals of Internal Medicine
K Rammohan, Shyma M Mundayadan, Robert Mathew
CONTEXT: Nummular headache (NH) is a primary disorder characterized by head pain exclusively felt in a small-rounded area typically 2-6 cm in diameter. AIMS: The aim of this review is to study the clinical and epidemiological features of NH in a patient population of South India and to compare this with that of described in the international literature. SETTINGS AND DESIGN: A prospective, observational study conducted in a tertiary care center...
October 2016: Journal of Neurosciences in Rural Practice
Lioudmila V Karnatovskaia, Margaret M Johnson, Travis J Dockter, Ognjen Gajic
PURPOSE: Survivors of critical illness are frequently unable to return to their premorbid level of psychocognitive functioning following discharge. Therefore, we aimed to evaluate the burden of psychological trauma experienced by patients in the intensive care unit (ICU) as perceived by clinicians to assess factors that can impede its recognition and treatment in the ICU. MATERIALS AND METHODS: Two distinct role-specific Web-based surveys were administered to critical care physicians and nurses in medical and surgical ICUs of 2 academic medical centers...
September 14, 2016: Journal of Critical Care
Phillip B Ham, Toby Anderton, Ryan Gallaher, Mike Hyrman, Erika Simmerman, Annamalai Ramanathan, David Fallaw, Steven Holsten, Charles Gordon Howell
Surgeons frequently report frustration and loss of efficiency with electronic medical record (EMR) systems. Together, surgery residents and a programmer at Augusta University created a rounds report (RR) summarizing 24 hours of vitals, intake/output, labs, and other values for each inpatient that were previously transcribed by hand. The objective of this study was to evaluate the RR's effect on surgery residents. Surgery residents were queried to assess the RR's impact. Outcome measures were time spent preparing for rounds, direct patient care time, educational activity time, rates of incorrect/incomplete data on rounds, and rate of duty hour violations...
September 2016: American Surgeon
Herbert Silverstein, Rosemary Ojo, Julie Daugherty, Ronen Nazarian, Jack Wazen
OBJECTIVE: To evaluate the efficacy of a minimally invasive surgical procedure in patients with severe hyperacusis. STUDY DESIGN: Prospective, longitudinal design. SETTING: Tertiary referral center. PATIENTS: Adult patients with history of severe hyperacusis. INTERVENTION: Using a transcanal approach, the round and oval window was reinforced with temporalis fascia or tragal perichondrium in six subjects (nine ears) and was subdivided into two groups (unilateral or bilateral reinforcement procedure)...
September 23, 2016: Otology & Neurotology
Marie Chinazzo, Gérard Lorette, Robert Baran, Antoine Finon, Élie Saliba, Annabel Maruani
INTRODUCTION: The anatomy and embryology of the nail are well known, and nail abnormalities are a feature of many genodermatoses. However, the physiological aspect is not well described. We aimed to analyse the physiological features of nails in healthy newborns. METHODS: We performed an observational, prospective study at University Hospital Center of Tours between July and October 2015. Newborns were included by a dermatologist assistant during the systematic examination on release of the mother from the hospital...
September 23, 2016: Journal of the European Academy of Dermatology and Venereology: JEADV
Katherine Treiman, Lauren McCormack, Murrey Olmsted, Nancy Roach, Bryce B Reeve, Christa E Martens, Rebecca R Moultrie, Hanna Sanoff
BACKGROUND: Patient-centered communication (PCC) is an essential component of patient-centered care and contributes to patient satisfaction, health-related quality of life, and other important patient outcomes. OBJECTIVE: The aim of this study was to develop and test survey questions to assess patients' experiences with PCC in cancer care. METHODS: We used a conceptual model developed by the National Cancer Institute as our framework. The survey questions align with the six core functions of PCC defined in the model: Exchanging Information, Managing Uncertainty, Enabling Patient Self-Management, Fostering Healing Relationships, Making Decisions, and Responding to Emotions...
September 23, 2016: Patient
M J Scheltema, K J Tay, A W Postema, D M de Bruin, J Feller, J J Futterer, A K George, R T Gupta, F Kahmann, C Kastner, M P Laguna, S Natarajan, S Rais-Bahrami, A R Rastinehad, T M de Reijke, G Salomon, N Stone, R van Velthoven, R Villani, A Villers, J Walz, T J Polascik, J J M C H de la Rosette
PURPOSE: To codify the use of multiparametric magnetic resonance imaging (mpMRI) for the interrogation of prostate neoplasia (PCa) in clinical practice and focal therapy (FT). METHODS: An international collaborative consensus project was undertaken using the Delphi method among experts in the field of PCa. An online questionnaire was presented in three consecutive rounds and modified each round based on the comments provided by the experts. Subsequently, a face-to-face meeting was held to discuss and finalize the consensus results...
September 16, 2016: World Journal of Urology
Ingo Todt, Philipp Mittmann, Arne Ernst
OBJECTIVE: The aim of this study was to observe the rate of hearing preservation with a midscalar electrode with two surgical approaches. STUDY DESIGN: Prospective study. SETTING: Tertiary referral center. PATIENTS: Twenty patients with residual hearing. Group A: 11 patients (mean age 56.1, 4 men, 7 women) mean HL 250 Hz, 36.4 dB; 500 Hz, 50.0 dB and 1 kHz, 81.4 dB. Group B: nine patients (mean age, 52.8 yr, 7 women, 2 men), 250 Hz, 36...
October 2016: Otology & Neurotology
Timothy Kubal, Doug G Letson, Alberto A Chiappori, Gregory M Springett, Riti Shimkhada, Diana Tamondong Lachica, John W Peabody
OBJECTIVES: This study examined whether a measurement and feedback system led to improvements in adherence to clinical pathways. DESIGN: The M-QURE (Moffitt-Quality, Understanding, Research and Evidence) Initiative was introduced in 2012 to enhance and improve adherence to pathways at Moffitt Cancer Center (MCC) in three broad clinical areas: breast, lung and gastrointestinal (GI) cancers. M-QURE used simulated patient vignettes based on MCC's Clinical Pathways to benchmark clinician adherence and monitor change over three rounds of implementation...
September 13, 2016: BMJ Open
Natasha Ghosh, Farida A Malik, Roshni G Daver, Jakapat Vanichanan, Pablo C Okhuysen
BACKGROUND: Viral associated diarrhea (VAD) due to Norovirus (NV), Rotavirus (RV) and Adenovirus (AV) is common in immunocompromised and cancer patients. We sought to determine if the clinical characteristics, morbidity and seasonality of infection differed according to the type of enteric virus identified. METHODS: Cases of NV, RV and AV were identified in stool specimens submitted to the clinical microbiology laboratory between November 2005 and February 2015...
September 13, 2016: Infectious Diseases
Mona Krouss, Jumana Alshaikh, Lindsay Croft, Daniel J Morgan
BACKGROUND: Preventable medical harm is a leading cause of death in the United States. Incident reporting systems have been identified as the primary method to capture medical error and harm. Incidents are rarely reported, particularly among physician trainees. METHODS: We conducted a single-center, quasi-experimental study to examine the effect of education on the importance of and how to file an incident report for physician trainees on reporting rates. Trainees were provided laminated plastic instructions, and reporting was reinforced with weekly patient safety rounds...
September 9, 2016: Journal of Patient Safety
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