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https://www.readbyqxmd.com/read/28603435/an-active-learning-curriculum-improves-fellows-knowledge-and-faculty-teaching-skills
#1
Jennifer A Inra, Stephen Pelletier, Navin L Kumar, Edward L Barnes, Helen M Shields
OBJECTIVES: Traditional didactic lectures are the mainstay of teaching for graduate medical education, although this method may not be the most effective way to transmit information. We created an active learning curriculum for Brigham and Women's Hospital (BWH) gastroenterology fellows to maximize learning. We evaluated whether this new curriculum improved perceived knowledge acquisition and knowledge base. In addition, our study assessed whether coaching faculty members in specific methods to enhance active learning improved their perceived teaching and presentation skills...
2017: Advances in Medical Education and Practice
https://www.readbyqxmd.com/read/28585909/agreement-analysis-comparing-ipad-lcva-and-sloan-testing-in-multiple-sclerosis-patients
#2
Neda Sattarnezhad, Samantha Farrow, Dorlan Kimbrough, Bonnie Glanz, Brian Healy, Tanuja Chitnis
BACKGROUND: Visual symptoms are common in multiple sclerosis (MS). Low-contrast visual acuity (LCVA) testing using Sloan charts has demonstrated increased sensitivity for visual deficits compared to high-contrast acuity testing. Computerized testing of visual acuity may facilitate use in the clinic setting. OBJECTIVES: To evaluate the agreement between an iPad-based and Sloan testing of LCVA in a cohort of MS patients. METHODS: A total of 38 patients with relapsing-remitting MS were enrolled after providing informed written consent at Partners MS Center, Brigham and Women's hospital...
June 1, 2017: Multiple Sclerosis: Clinical and Laboratory Research
https://www.readbyqxmd.com/read/28577841/aortic-atheroma-increases-the-risk-of-long-term-mortality-in-20-000-patients
#3
Carolyn Goldberg Butler, Jamahal Maeng Ho Luxford, Chuan-Chin Huang, Julius I Ejiofor, James D Rawn, Kerry Wilusz, John A Fox, Stanton K Shernan, Jochen Daniel Muehlschlegel
BACKGROUND: The association between long-term survival and aortic atheroma in cardiac surgical patients has not been comprehensively investigated. In this study we determine the relation between grade of atheroma and the risk of long-term mortality in a retrospective cohort of more than 20,000 patients undergoing cardiac operation during a 20-year period. METHODS: We included 22,304 consecutive intraoperative transesophageal and epiaortic ultrasound examinations performed at Brigham and Women's Hospital between 1995 and 2014, with long-term follow-up...
June 1, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28544102/a-multicenter-retrospective-case-cohort-study-of-the-epidemiology-and-risk-factors-for-clostridium-difficile-infection-among-cord-blood-transplant-recipients
#4
Carolyn D Alonso, David A Braun, Ishan Patel, Mona Akbari, Daniel Jungmyung Oh, Tomi Jun, Malgorzata McMasters, Sarah P Hammond, Brett Glotzbecker, Corey Cutler, Daniel Leffler, Karen K Ballen, CiarĂ¡n P Kelly
BACKGROUND: Clostridium difficile infection (CDI) is the leading cause of health-care associated infectious diarrhea. The aim of this study was to evaluate the epidemiology and risk factors for CDI in the 100 days following umbilical cord blood transplantation (UCBT) at three Boston hospitals. METHODS: We performed a multicenter, retrospective, case-cohort study of 226 UCBT recipients at Beth Israel Deaconess Medical Center, Massachusetts General Hospital, and Dana Farber/Brigham and Women's Cancer Center from 2003-2012...
May 24, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28527078/our-headache-fellowship-a-10-year-history
#5
Paul Rizzoli
There has been a clear trend in American medical education after World War II toward training specialization and subspecialization. After some early specialization efforts by the American Board of Psychiatry and Neurology, further efforts were undertaken by the United Council for Neurologic Subspecialties (UCNS), leading to the introduction of the neurologic subspecialty of Headache Medicine in March, 2005. The training program at our center at the Brigham and Women's Hospital Department of Neurology, Harvard Medical School, in Boston, Massachusetts, was accredited in 2008 and has graduated 14 trainees since its inception...
May 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28520927/preoperative-stratification-of-transsphenoidal-pituitary-surgery-patients-based-on-surgical-urgency
#6
Hasan A Zaidi, Amy J Wang, David J Cote, Timothy R Smith, Daniel Prevedello, Domenico Solari, Paolo Cappabianca, Monica Quiroga, Edward R Laws
BACKGROUND: Currently, there is no prioritization scale available to distinguish those patients with pituitary tumors who require urgent surgical intervention from those who are candidates for elective treatment. OBJECTIVE: To develop a classification system that can help primary care physicians, endocrinologists, neurosurgeons, ancillary support staff, and hospital administrators identify high-priority surgical candidates. METHODS: An expert international panel of clinicians consisting of endocrinologists and neurosurgeons who are involved in the diagnosis and management of sellar disease was convened...
May 18, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28486603/clinical-identification-of-oncogenic-drivers-and-copy-number-alterations-in-pituitary-tumors
#7
Wenya Linda Bi, Noah F Greenwald, Shakti H Ramkissoon, Malak Abedalthagafi, Shannon M Coy, Keith L Ligon, Yu Mei, Laura MacConaill, Matt Ducar, Le Min, Sandro Santagata, Ursula B Kaiser, Rameen Beroukhim, Edward R Laws, Ian F Dunn
Pituitary tumors are the second most common adult primary brain tumor, with a variable clinical course. Recent work has identified a number of genetic determinants of pituitary tumor subtypes, which may augment classic histopathologic classification schemes. We sought to determine whether pituitary tumors could be stratified based on objective molecular characteristics using a clinical genomics assay. We profiled pituitary tumors using OncoPanel, a clinical multiplexed next-generation sequencing assay and retrospectively collected the clinical information and sequencing results for 127 patients from 2012-2016 at the Brigham and Women's Hospital...
May 8, 2017: Endocrinology
https://www.readbyqxmd.com/read/28486371/trends-in-mode-of-hysterectomy-after-the-u-s-food-and-drug-administration-power-morcellation-advisory
#8
Helga Ottarsdottir, Sarah L Cohen, Mary Cox, Allison Vitonis, Jon I Einarsson
OBJECTIVE: To evaluate the trends in mode of surgery for benign hysterectomy after the 2014 U.S. Food and Drug Administration (FDA) morcellation guidelines. METHODS: This is a retrospective review of all patients who underwent a hysterectomy for benign indications, specifically for leiomyomas, at Brigham and Women's Hospital from 2013 to 2015. The rates of abdominal, vaginal, laparoscopic, and robotic-assisted laparoscopic hysterectomy as well as the perioperative outcomes were compared over the study period...
June 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28447007/minimally-invasive-esophagectomy-the-brigham-and-women-s-hospital-experience
#9
REVIEW
Jon O Wee, Raphael Bueno, Scott J Swanson
No abstract text is available yet for this article.
March 2017: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28426563/routine-inclusion-of-long-term-functional-and-patient-reported-outcomes-into-trauma-registries-the-forte-project
#10
Arturo J Rios-Diaz, Juan P Herrera-Escobar, Elizabeth J Lilley, Jessica R Appelson, Belinda Gabbe, Karen Brasel, Terri deRoon-Cassini, Eric B Schneider, George Kasotakis, Haytham Kaafarani, George Velmahos, Ali Salim, Adil H Haider
BACKGROUND: The National Academies of Sciences, Engineering, and Medicine (formerly the Institute of Medicine) recently recommended inclusion of postdischarge health-related quality of life (HRQoL) and patient-reported outcomes (PROs) metrics to benchmark the quality of trauma care. Currently, these measures are not routinely collected at most trauma centers. We sought to determine the feasibility and value of adding such long-term outcome measures to trauma registries. METHODS: As part of the FORTE (Functional Outcomes and Recovery after Trauma Emergencies) project, we included patients with an Injury Severity Score of 9 or greater, admitted to the Brigham and Women's Hospital in Boston, MA, who were identified retrospectively using the institutional trauma registry and contacted 6 or 12 months after injury to participate in a telephone survey evaluating HRQoL (Short Form 12 [SF-12]), PROs (Trauma Quality of Life), posttraumatic stress disorder, return to work, residential status, and health care utilization...
July 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28378409/diffusion-of-digital-breast-tomosynthesis-among-women-in-primary-care-associations-with-insurance-type
#11
Cheryl R Clark, Tor D Tosteson, Anna N A Tosteson, Tracy Onega, Julie E Weiss, Kimberly A Harris, Jennifer S Haas
Digital breast tomosynthesis (DBT) has shown potential to improve breast cancer screening and diagnosis compared to digital mammography (DM). The FDA approved DBT use in conjunction with conventional DM in 2011, but coverage was approved by CMS recently in 2015. Given changes in coverage policies, it is important to monitor diffusion of DBT by insurance type. This study examined DBT trends and estimated associations with insurance type. From June 2011 to September 2014, DBT use in 22 primary care centers in the Dartmouth -Brigham and Women's Hospital Population-based Research Optimizing Screening through Personalized Regimens research center (PROSPR) was examined among women aged 40-89...
May 2017: Cancer Medicine
https://www.readbyqxmd.com/read/28377941/proof-of-concept-for-a-novel-curriculum-learning-a-second-language-during-anesthesiology-residency
#12
Kate Mitchell Cohen, Alvaro Andres Macias, Robert Lekowski, Mercedes Concepcion, Jose Zeballos
This article describes a novel curriculum for anesthesiology residents matriculating through Brigham and Women's Department of Anesthesiology. It is offered electively and provides physician residents with time to acquire language skills through a medically-focused immersion program abroad. It is designed for them to learn or improve a second language and then to speak it while practicing perioperative medicine. Ultimately, the elective curriculum will equip future anesthesiologists with the communication tools to deliver professional and compassionate patient care both within the United States and internationally...
January 2017: Journal of Education in Perioperative Medicine: JEPM
https://www.readbyqxmd.com/read/28347447/user-requirements-for-a-chronic-kidney-disease-clinical-decision-support-tool-to-promote-timely-referral
#13
Joy Gulla, Pamela M Neri, David W Bates, Lipika Samal
BACKGROUND: Timely referral of patients with CKD has been associated with cost and mortality benefits, but referrals are often done too late in the course of the disease. Clinical decision support (CDS) offers a potential solution, but interventions have failed because they were not designed to support the physician workflow. We sought to identify user requirements for a chronic kidney disease (CKD) CDS system to promote timely referral. METHODS: We interviewed primary care physicians (PCPs) to identify data needs for a CKD CDS system that would encourage timely referral and also gathered information about workflow to assess risk factors for progression of CKD...
May 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/28345442/predicting-1-year-statin-adherence-among-prevalent-users-a-retrospective-cohort-study
#14
Alexis A Krumme, Jessica M Franklin, Danielle L Isaman, Olga S Matlin, Angela Y Tong, Claire M Spettell, Troyen A Brennan, William H Shrank, Niteesh K Choudhry
BACKGROUND: Attempts to predict who is at risk of future nonadherence have largely focused on predictions at the time of therapy initiation; however, these users are only a small proportion of all patients on therapy at any point in time. Methods to predict nonadherence for established medication users, which have not been previously described in the literature, would be helpful to guide efforts to enhance the use of evidence-based therapies. OBJECTIVE: To test approaches for adherence prediction among prevalent statin users, namely the use of short-term filling behavior, investigator-specified predictors from medical and pharmacy administrative claims, and the empirical selection of potential predictors using the high-dimensional propensity score variable selection algorithm...
April 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28334567/review-of-nonformulary-medication-approvals-in-an-academic-medical-center
#15
Qoua L Her, Mary G Amato, Diane L Seger, James F Gilmore, John Fanikos, Julie M Fiskio, David W Bates
BACKGROUND: The Joint Commission requires hospitals to formally review formulary medications at least annually based on new clinical information. Although review of nonformulary medication (NFM) use is not required, frequent and inappropriate use of NFMs has the potential to increase hospital costs, negatively affect quality of care, and increase medication errors. Limited resources may restrict an institution's ability to review NFM use in addition to the required annual formulary review...
February 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28328735/building-workforce-capacity-abroad-while-strengthening-global-health-programs-at-home-participation-of-seven-harvard-affiliated-institutions-in-a-health-professional-training-initiative-in-rwanda
#16
Corrado Cancedda, Robert Riviello, Kim Wilson, Kirstin W Scott, Meenu Tuteja, Jane R Barrow, Bethany Hedt-Gauthier, Gene Bukhman, Jennifer Scott, Danny Milner, Giuseppe Raviola, Barbara Weissman, Stacy Smith, Tej Nuthulaganti, Craig D McClain, Barbara E Bierer, Paul E Farmer, Anne E Becker, Agnes Binagwaho, Joseph Rhatigan, David E Golan
A consortium of 22 U.S. academic institutions is currently participating in the Rwanda Human Resources for Health Program (HRH Program). Led by the Rwandan Ministry of Health and funded by both the U.S. Government and the Global Fund to Fight AIDS, Tuberculosis and Malaria, the primary goal of this seven-year initiative is to help Rwanda train the number of health professionals necessary to reach the country's health workforce targets. Since 2012, the participating U.S. academic institutions have deployed faculty from a variety of health-related disciplines and clinical specialties to Rwanda...
May 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28267211/retrospective-review-of-serotonergic-medication-tolerability-in-patients-with-neuroendocrine-tumors-with-biochemically-proven-carcinoid-syndrome
#17
Diana D Shi, David P Yuppa, Trevor Dutton, Lauren K Brais, Sarah L Minden, Ilana M Braun, Matthew H Kulke, Jennifer A Chan, Fremonta L Meyer
BACKGROUND: Patients with carcinoid tumors frequently could benefit from the pharmacologic treatment of depression and anxiety. However, many prescribers avoid serotonergic medications due to the theoretical risk of exacerbating carcinoid syndrome. METHODS: The authors conducted a retrospective chart review of patients with carcinoid tumors and elevated serotonin levels (as measured by 24-hour urine 5-hydroxyindoleacetic acid [5-HIAA]) at Dana-Farber/Brigham and Women's Cancer Center who initiated treatment with serotonergic antidepressants after a carcinoid diagnosis from 2003 to 2016...
March 7, 2017: Cancer
https://www.readbyqxmd.com/read/28264721/densitometric-and-local-histogram-based-analysis-of-computed-tomography-images-in-patients-with-idiopathic-pulmonary-fibrosis
#18
Samuel Y Ash, Rola Harmouche, Diego Lassala Lopez Vallejo, Julian A Villalba, Kris Ostridge, River Gunville, Carolyn E Come, Jorge Onieva Onieva, James C Ross, Gary M Hunninghake, Souheil Y El-Chemaly, Tracy J Doyle, Pietro Nardelli, Gonzalo V Sanchez-Ferrero, Hilary J Goldberg, Ivan O Rosas, Raul San Jose Estepar, George R Washko
BACKGROUND: Prior studies of clinical prognostication in idiopathic pulmonary fibrosis (IPF) using computed tomography (CT) have often used subjective analyses or have evaluated quantitative measures in isolation. This study examined associations between both densitometric and local histogram based quantitative CT measurements with pulmonary function test (PFT) parameters and mortality. In addition, this study sought to compare risk prediction scores that incorporate quantitative CT measures with previously described systems...
March 7, 2017: Respiratory Research
https://www.readbyqxmd.com/read/28244949/cross-disciplinary-perceptions-of-structured-interprofessional-rounds-in-promoting-teamwork-within-an-academic-tertiary-care-obstetric-unit
#19
Anthony Chau, Mary A Vijjeswarapu, Margaret Hickey, David Acker, Chuan-Chin Huang, Lawrence C Tsen
BACKGROUND: In 2005, physician and nursing leaders at Brigham and Women's Hospital initiated structured interprofessional rounds (SIPRs) on the labor and delivery (L&D) suite to improve team communication. We performed a cross-sectional analysis of providers' perceptions of SIPRs and their effectiveness in improving teamwork. We hypothesized that on average, providers would perceive SIPRs as being effective in promoting teamwork, but ratings would differ among professional groups. METHODS: After a factor analysis and internal consistency assessment, a 19-item paper-based questionnaire was used to evaluate providers' perceptions using a 5-point Likert scale...
June 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28244139/quantitative-computed-tomography-assessment-of-bronchiolitis-obliterans-syndrome-after-lung-transplantation
#20
Lee Gazourian, Samuel Ash, Emily E K Meserve, Alejandro Diaz, Raul San Jose Estepar, Souheil Y El-Chemaly, Ivan O Rosas, Miguel Divo, Anne L Fuhlbrigge, Phillip C Camp, Vincent T Ho, Ami S Bhatt, Hilary J Goldberg, Lynette M Sholl, George R Washko
BACKGROUND: Bronchiolitis obliterans syndrome (BOS) is a clinical manifestation of chronic allograft rejection following lung transplantation. We examined the quantitative measurements of the proximal airway and vessels and pathologic correlations in subjects with BOS. METHODS: Patients who received a lung transplant at the Brigham and Women's Hospital between December 1, 2002 and December 31, 2010 were included in this study. We characterized the quantitative CT measures of proximal airways and vessels and pathological changes...
May 2017: Clinical Transplantation
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