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Pulmonology and critical care

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https://www.readbyqxmd.com/read/29706056/changes-in-medical-care-due-to-the-absence-of-internal-medicine-physicians-in-emergency-departments
#1
Kyoung Ho Kim, Jang Young Lee, Won Suk Lee, Won Young Sung, Sang Won Seo
Objective: Especially in emergency departments (EDs), a lack of internal medicine (IM) residents in charge causes difficulties in medical care and ED overcrowding. Thus, protocols without IM residents in EDs is needed. This study aimed to investigate changes in medical care when emergency medicine residents replaced the roles of IM residents. Methods: This study was conducted at a single-site ED of a university medical center. The study group contained patients admitted to the IM department between September and December 2015, during which IM residents were absent in the ED...
April 30, 2018: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/29670358/multidisciplinary-approach-to-the-management-of-pulmonary-embolism-patients-the-pulmonary-embolism-response-team-pert
#2
REVIEW
Christopher W Root, David M Dudzinski, Bishoy Zakhary, Oren A Friedman, Akhilesh K Sista, James M Horowitz
Pulmonary embolism (PE) is a potentially fatal disease with a broad range of treatment options that spans multiple specialties. The rapid evolution and expansion of novel therapies to treat PE make it a disease process that is well suited to a multidisciplinary approach. In order to facilitate a rapid, robust response to the diagnosis of PE, some hospitals have established multidisciplinary pulmonary embolism response teams (PERTs). The PERT model is based on existing multidisciplinary teams such as heart teams and rapid response teams...
2018: Journal of Multidisciplinary Healthcare
https://www.readbyqxmd.com/read/29648880/evolving-challenges-in-pediatric-pulmonary-medicine-new-opportunities-to-re-invigorate-the-field
#3
Joseph M Collaco, Steven H Abman
Thirty years after the first board certification examination for pediatric pulmonology was administered there remain substantial challenges in attracting trainees and sustaining and retaining clinician-scientists in the field. In fact, significant workforce shortages are predicted to exist with current fellowship graduation rates and the aging of the existing workforce. However, the rapid diagnostic and therapeutic advances occurring in the field should serve as draw for trainees. In addition, pediatric pulmonologists provide unique expertise for the diversity and severity of respiratory conditions that is not duplicated by generalists, allergists, intensivists, or neonatologists...
April 12, 2018: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29395185/variation-in-part-time-work-among-pediatric-subspecialties
#4
Gary L Freed, Debra M Boyer, Kenton D Van, Michelle L Macy, Julie McCormick, Laurel K Leslie
OBJECTIVE: To assess the part-time workforce and average hours worked per week among pediatric subspecialists in the 15 medical subspecialties certified by the American Board of Pediatrics. STUDY DESIGN: We examined data from pediatric subspecialists who enrolled in Maintenance of Certification with the American Board of Pediatrics from 2009 to 2015. Data were collected via an online survey. Providers indicated whether they worked full time or part time and estimated the average number of hours worked per week in clinical, research, education, and administrative tasks, excluding time on call...
April 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29098756/reducing-the-risk-of-healthcare-associated-infections-through-lean-six-sigma-the-case-of-the-medicine-areas-at-the-federico-ii-university-hospital-in-naples-italy
#5
Giovanni Improta, Mario Cesarelli, Paolo Montuori, Liberatina Carmela Santillo, Maria Triassi
RATIONALE, AIMS, AND OBJECTIVES: Lean Six Sigma (LSS) has been recognized as an effective management tool for improving healthcare performance. Here, LSS was adopted to reduce the risk of healthcare-associated infections (HAIs), a critical quality parameter in the healthcare sector. METHODS: Lean Six Sigma was applied to the areas of clinical medicine (including general medicine, pulmonology, oncology, nephrology, cardiology, neurology, gastroenterology, rheumatology, and diabetology), and data regarding HAIs were collected for 28,000 patients hospitalized between January 2011 and December 2016...
April 2018: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28978238/ototoxicity-monitoring-through-the-eyes-of-the-treating-physician-perspectives-from-pulmonology-and-medical-oncology
#6
Angela C Garinis, Alexandra Cornell, Gopal Allada, Kevin P Fennelly, Ronald J Maggiore, Dawn Konrad-Martin
OBJECTIVES: Integrating audiological management into the care pathways of clinical specialties that prescribe ototoxic medications for essential, often life-preserving medical care that is critical for early hearing loss identification and remediation. Research shows that successful implementation of a new health service or intervention requires alignment of goals among provider groups, institutional leadership and patients. Thoughtful consideration of the physician's viewpoints about ototoxicity and its implications for treatment planning is, therefore, important for the implementation and enduring success of an ototoxicity monitoring programme (OMP)...
October 5, 2017: International Journal of Audiology
https://www.readbyqxmd.com/read/28900356/humidifiers-for-oxygen-therapy-what-risk-for-reusable-and-disposable-devices
#7
REVIEW
V La Fauci, G B Costa, A Facciolà, A Conti, R Riso, R Squeri
INTRODUCTION: Nosocomial pneumonia accounts for the vast majority of healthcare-associated infections (HAI). Although numerous medical devices have been discussed as potential vehicles for microorganisms, very little is known about the role played by oxygen humidifiers as potential sources of nosocomial pathogens. The purpose of this research was to evaluate the safety of the reuse of humidifiers by analysing the rate of microbial contamination in reusable and disposable oxygen humidifiers used during therapy, and then discuss their potential role in the transmission of respiratory pathogens...
June 2017: Journal of Preventive Medicine and Hygiene
https://www.readbyqxmd.com/read/28887926/developing-an-extracorporeal-membrane-oxygenation-program
#8
REVIEW
Julia Jones-Akhtarekhavari, Thomas A Tribble, Joseph B Zwischenberger
The development of a successful extracorporeal membrane oxygenation (ECMO) program requires an institutional commitment and the multidisciplinary cooperation of trained specialty personnel from nursing, internal medicine, anesthesiology, pulmonology, emergency medicine, critical care, and surgery and often pediatrics as well. The specialized training necessary to cultivate an integrated team capable of providing life-saving ECMO cannot be underestimated. The development of a successful ECMO program is best suited to a tertiary medical center that is centrally/regionally located and capable of financially supporting the level of expertise required as well as managing the program's overall cost effectiveness...
October 2017: Critical Care Clinics
https://www.readbyqxmd.com/read/28877109/the-efficacy-of-a-viscoelastic-foam-overlay-on-prevention-of-pressure-injury-in-acutely-ill-patients-a-prospective-randomized-controlled-trial
#9
RANDOMIZED CONTROLLED TRIAL
Kyung Hee Park, Joohee Park
PURPOSE: The purpose of this study was to compare a viscoelastic foam overlay (VEFO) to a standard hospital mattress for pressure injury (PI) prevention. We also compared interface pressures (IPs) of the VEFO to our facility's standard hospital mattress. DESIGN: Prospective, randomized controlled trial. SUBJECTS AND SETTING: Data analysis was based on 110 participants (55 in each group) who were 19 years or older, had a Braden Scale for Pressure Sore Risk score of 16 or less, and were cared for on a neurology, oncology, or pulmonology inpatient care unit...
September 2017: Journal of Wound, Ostomy, and Continence Nursing
https://www.readbyqxmd.com/read/28437370/ethics-guide-recommendations-for-organ-donation-focused-physicians-endorsed-by-the-canadian-medical-association
#10
Sam D Shemie, Christy Simpson, Jeff Blackmer, Shavaun MacDonald, Sonny Dhanani, Sylvia Torrance, Paul Byrne
Donation physicians are specialists with expertise in organ and tissue donation and have been recognized internationally as a key contributor to improving organ and tissue donation services. Subsequent to a 2011 Canadian Critical Care Society-Canadian Blood Services consultation, the donation physician role has been gradually implemented in Canada. These professionals are generally intensive care unit physicians with an enhanced focus and expertise in organ/tissue donation. They must manage the dual obligation of caring for dying patients and their families while providing and/or improving organ donation services...
May 2017: Transplantation
https://www.readbyqxmd.com/read/28138915/evaluation-of-internet-based-patient-education-materials-from-internal-medicine-subspecialty-organizations-will-patients-understand-them
#11
David R Hansberry, Nitin Agarwal, Elizabeth S John, Ann M John, Prateek Agarwal, James C Reynolds, Stephen R Baker
The majority of Americans use the Internet daily, if not more often, and many search online for health information to better understand a diagnosis they have been given or to research treatment options. The average American reads at an eighth-grade level. The purpose of this study is to evaluate the readability of online patient education materials on the websites of 14 professional organizations representing the major internal medicine subspecialties. We used ten well-established quantitative readability scales to assess written text from patient education materials published on the websites of the major professional organizations representing the following subspecialty groups: allergy and immunology, cardiology, endocrinology, gastroenterology, geriatrics, hematology, hospice and palliative care, infectious disease, nephrology, oncology, pulmonology and critical care, rheumatology, sleep medicine, and sports medicine...
June 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/27987505/-patient-related-independent-clinical-risk-factors-for-early-complications-following-interventional-pulmonology-procedures
#12
J J Huang, H Zhang, W Zhang, X Wang, Y H Gong, G F Wang
OBJECTIVE: To investigate the early complication rate and identify patient-related independent clinical risk factors for early complications in patients following interventional pulmonology procedures. METHODS: In the period from December 2014 to December 2015, sufficient data of Peking University First Hospital Respiratory and Critical Care Medicine Department for analysis were identified in 218 subjects. Interventional pulmonology procedures were performed in all the patients...
December 18, 2016: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/27916027/-current-status-of-lung-transplantation-in-china-problems-and-perspectives
#13
X A Wang, G N Jiang
Despite rapid progress, clinical lung transplantation in China still lags far behind. A great challenge remains in donor lung utilization and perioperative medicine. It's really abnormal that we are so backward in lung transplantation when we have come up with the advanced world levels in thoracic surgery, pulmonology and critical care medicine. Our shortcomings were analyzed by comparing lung transplantation in China and in the advanced countries. The first problem is multidisciplinary teamwork. In the United States, a lung transplant team includes physician specialized in lung transplantation, thoracic surgeons, nurses, respiratory therapists and other specialists possibly needed...
December 1, 2016: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/27628103/significance-of-frailty-for-predicting-adverse-clinical-outcomes-in-different-patient-groups-with-specific-medical-conditions
#14
Martin Ritt, Karl-Günter Gaßmann, Cornel Christian Sieber
Frailty is a major health burden in an aging society. It constitutes a clinical state of reduced physiological reserves that is associated with a diminished ability to withstand internal and external stressors. Frail patients have an increased risk for adverse clinical outcomes, such as mortality, readmission to hospital, institutionalization and falls. Of further clinical interest, frailty might be at least in part reversible in some patients and subject to preventive strategies. In daily clinical practice older patients with a complex health status, who are mostly frail or at least at risk of developing frailty, are frequently cared for by geriatricians...
October 2016: Zeitschrift Für Gerontologie und Geriatrie
https://www.readbyqxmd.com/read/27555314/the-virtual-obstetrical-intensive-care-unit-providing%C3%A2-critical-care-for-contemporary-obstetrics-in%C3%A2-nontraditional%C3%A2-locations
#15
Michael P Leovic, Hailey N Robbins, Michael R Foley, Roman S Starikov
Management of the critically ill pregnant patient presents a clinical dilemma in which there are sparse objective data to determine the optimal setting for provision of high-quality care to these patients. This clinical scenario will continue to present a challenge for providers as the chronic illness and comorbid conditions continue to become more commonly encountered in the obstetric population. Various care models exist across a broad spectrum of facilities that are characterized by differing levels of resources; however, no studies have identified which model provides the highest level of care and patient safety while maintaining a reasonable degree of cost-effectiveness...
December 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27358351/synergy-salary-and-satisfaction-benefits-of-training-in-critical-care-medicine-and-infectious-diseases-gleaned-from-a-national-pilot-survey-of-dually-trained-physicians
#16
Sameer S Kadri, Chanu Rhee, Gabriela Magda, Jeffrey R Strich, Rongman Cai, Junfeng Sun, Brooke K Decker, Naomi P O'Grady
BACKGROUND: An increasing number of physicians are seeking dual training in critical care medicine (CCM) and infectious diseases (ID). Understanding experiences and perceptions of CCM-ID physicians could inform career choices and programmatic innovation. METHODS: All physicians trained and/or certified in both CCM and ID to date in the United States were sent a Web-based questionnaire in 2015. Responses enabled a cross-sectional analysis of physician demographics and training and practice characteristics and satisfaction...
October 1, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/27048508/diagnosing-sepsis-is-subjective-and-highly-variable-a-survey-of-intensivists-using-case-vignettes
#17
Chanu Rhee, Sameer S Kadri, Robert L Danner, Anthony F Suffredini, Anthony F Massaro, Barrett T Kitch, Grace Lee, Michael Klompas
BACKGROUND: Sepsis is the focus of national quality improvement programs and a recent public reporting measure from the Centers for Medicare and Medicaid Services. However, diagnosing sepsis requires interpreting nonspecific signs and can therefore be subjective. We sought to quantify interobserver variability in diagnosing sepsis. METHODS: We distributed five case vignettes of patients with suspected or confirmed infection and organ dysfunction to a sample of practicing intensivists...
April 6, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/26989810/development-of-a-tool-to-assess-basic-competency-in-the-performance-of-rigid-bronchoscopy
#18
Kamran Mahmood, Momen M Wahidi, Kathryn E Osann, Kathleen Coles, Scott L Shofer, Ellen E Volker, Mohsen Davoudi
RATIONALE: Rigid bronchoscopy is increasingly used by pulmonologists for the management of central airway disorders. However, an assessment tool to evaluate the competency of operators in the performance of this technique has not been developed. We created the Rigid Bronchoscopy Tool for Assessment of Skills and Competence (RIGID-TASC) to serve as an objective, competency-oriented assessment tool of basic rigid bronchoscopic skills, including rigid bronchoscopic intubation and central airway navigation...
April 2016: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/26807289/training-program-of-interventional-pulmonology-fellowships-usa
#19
REVIEW
Hans J Lee, Ashutosh Sachdeva
Interventional pulmonary (IP) is an emerging subspecialty of pulmonary medicine which focuses on procedures of the airway, lung, and pleura. As the number of advance procedures increases with the growth of this field, additional formal training is required to offer the full complement of techniques. IP fellowship is a dedicated 12 months fellowship in the United States which occurs after pulmonary/critical care fellowship. There have been several recent milestones in this field which include validated exams based on didactic knowledge and structural organization of fellowship organizations...
December 2015: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/26664711/case-report-pulmonary-kaposi-sarcoma-in-a-non-hiv-patient
#20
Arber Kodra, Maciej Walczyszyn, Craig Grossman, Daniel Zapata, Tarak Rambhatla, Bushra Mina
Kaposi Sarcoma (KS) is an angioproliferative tumor associated with human herpes virus 8 (HHV-8).  Often known as one of the acquired immunodeficiency syndrome (AIDS)-defining skin diseases, pulmonary involvement in KS has only been discussed in a handful of case reports, rarely in a non-HIV patient. Herein we report the case of a 77 year-old- male who presented with a 6-week history of progressive dyspnea on exertion accompanied by productive cough of yellow sputum and intermittent hemoptysis. His past medical history was significant for Non-Hodgkin's Follicular B-Cell Lymphoma (NHL)...
2015: F1000Research
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