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https://www.readbyqxmd.com/read/28648217/integrating-research-quality-improvement-and-medical-education-for-better-handoffs-and-safer-care-disseminating-adapting-and-implementing-the-i-pass-program
#1
Amy J Starmer, Nancy D Spector, Daniel C West, Rajendu Srivastava, Theodore C Sectish, Christopher P Landrigan
BACKGROUND: In 2009 the I-PASS Study Group was formed by patient safety, medical education, health services research, and clinical experts from multiple institutions in the United States and Canada. When the I-PASS Handoff Program, which was developed by the I-PASS Study Group, was implemented in nine hospitals, it was associated with a 30% reduction in injuries due to medical errors and significant improvements in handoff processes, without any adverse effects on provider work flow. METHODS: To effectively disseminate and adapt I-PASS for use across specialties and disciplines, a series of federally and privately funded dissemination and implementation projects were carried out following the publication of the initial study...
July 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28615355/reducing-unnecessary-imaging-for-patients-with-constipation-in-the-pediatric-emergency-department
#2
Catherine Craun Ferguson, Matthew P Gray, Melissa Diaz, Kevin P Boyd
OBJECTIVES: Constipation is a common diagnosis in the pediatric emergency department (ED). Children diagnosed with constipation may undergo an abdominal radiograph (AXR) as part of their diagnostic workup despite studies that suggest that an AXR in a patient suspected of being constipated is unnecessary and potentially misleading. We aimed to decrease the percentage of low-acuity patients aged between 6 months and 18 years diagnosed with constipation who undergo an AXR in our pediatric ED from 60% to 20% over 12 months...
June 14, 2017: Pediatrics
https://www.readbyqxmd.com/read/28614078/-development-of-a-clinical-ethics-committee-de-novo-at-a-small-community-hospital-by-addressing-needs-and-potential-barriers
#3
Bonnie H Arzuaga
Hospital ethics committees are common, but not universal, in small hospitals. A needs assessment was completed at a 155-bed community hospital in order to adapt an academic tertiary center model for a clinical ethics committee to fit the needs of the small hospital community. Of 678 questionnaires distributed, 209 were completed. Data suggested that clinical staff frequently experienced ethical dilemmas. Significantly more nonphysicians indicated that they would utilize a consultation service, if available, compared to physicians (p = 0...
2017: Journal of Clinical Ethics
https://www.readbyqxmd.com/read/28593381/paraspinal-hibernoma-grand-round-presentation-of-a-rare-benign-adipocytic-tumor
#4
Soufiane Ghailane, Houssam Bouloussa, Sandra Fauquier, Caroline Ziadé, Olivier Gille
INTRODUCTION: We report an uncommon case of paraspinal hibernoma with a T12-L1 foraminal extension and discuss the potential differential diagnoses of paraspinal adipocytic tumors. MATERIALS AND METHODS: A 32-year-old woman consulted our department with a right subscapular and paraspinal mass. There was no associated neurological deficit. The MRI revealed a paraspinal adipocytic tumor with a T12-L1 right foraminal extension. Percutaneous biopsy suggested a diagnosis of hibernoma...
June 7, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28586904/should-this-patient-have-weight-loss-surgery-grand-rounds-discussion-from-beth-israel-deaconess-medical-center
#5
Gerald W Smetana, Daniel B Jones, Christina C Wee
Obesity is an important public health priority in the United States. One third of U.S. adults are obese and therefore can expect higher rates of diabetes mellitus, other obesity-related comorbidities, and mortality. In 2013, the American Association of Clinical Endocrinologists, the Obesity Society, and the American Society for Metabolic and Bariatric Surgery issued a guideline that recommended weight loss (bariatric) surgery for all patients with a body mass index (BMI) of 40 kg/m2 or higher and for those with a BMI of 35 kg/m2 or greater in the presence of at least 1 obesity-related comorbidity...
June 6, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28580881/blocking-the-cycle-cyclin-dependent-kinase-4-6-inhibitors-in-metastatic-hormone-receptor-positive-breast-cancer
#6
Seth A Wander, Erica L Mayer, Harold J Burstein
The Oncology Grand Rounds series is designed to place original reports published in the Journal into clinical context. A case presentation is followed by a description of diagnostic and management challenges, a review of the relevant literature, and a summary of the authors' suggested management approaches. The goal of this series is to help readers better understand how to apply the results of key studies, including those published in Journal of Clinical Oncology, to patients seen in their own clinical practice...
June 3, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28536081/structural-annotation-of-beta-1-4-n-acetyl-galactosaminyltransferase-1-b4galnt1-causing-hereditary-spastic-paraplegia-26
#7
Rubina Dad, Uzma Malik, Aneela Javed, Berge A Minassian, Muhammad Jawad Hassan
Beta-1,4-N-acetyl galactosaminyltransferase 1, B4GALNT1, is a GM2/GD2 synthase, involved in the expression of glycosphingolipids (GSLs) containing sialic acid. Mutations in the gene B4GALNT1 cause Hereditary Spastic Paraplegia 26 (HSP26). In present study we have made attempt to predict the potential structural of the human B4GALNT1 protein. The results illustrated that the amino acid sequences of B4GALNT1 are not 100% conserved among selected twenty species. One signal peptide and one transmembrane domain predicted in human wild type B4GALNT1 protein with aliphatic index of 92...
May 20, 2017: Gene
https://www.readbyqxmd.com/read/28526311/dramatic-effects-of-a-new-antimicrobial-stewardship-program-in-a-rural-community-hospital
#8
Claudia R Libertin, Stephanie H Watson, William L Tillett, Joy H Peterson
BACKGROUND: New Joint Commission antimicrobial stewardship requirements took effect on January 1, 2017, promoted as a central strategy for coping with the emerging problems of antimicrobial resistance and Clostridium difficile infection. Our objective was to measure the effects of a new antimicrobial stewardship program (ASP) in a rural community hospital with no prior ASP, in the context of having a new infectious disease specialist on staff. METHODS: An ASP team was formed to implement a prospective audit with health care provider feedback and targeting 12 antimicrobial agents in a rural hospital in Georgia...
May 16, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28506360/plasmodium-p36-determines-host-cell-receptor-usage-during-sporozoite-invasion
#9
Giulia Manzoni, Carine Marinach, Selma Topçu, Sylvie Briquet, Morgane Grand, Matthieu Tolle, Marion Gransagne, Julien Lescar, Chiara Andolina, Jean-François Franetich, Mirjam B Zeisel, Thierry Huby, Eric Rubinstein, Georges Snounou, Dominique Mazier, François Nosten, Thomas F Baumert, Olivier Silvie
Plasmodium sporozoites, the mosquito-transmitted forms of the malaria parasite, first infect the liver for an initial round of replication before the emergence of pathogenic blood stages. Sporozoites represent attractive targets for antimalarial preventive strategies, yet the mechanisms of parasite entry into hepatocytes remain poorly understood. Here we show that the two main species causing malaria in humans, Plasmodium falciparum and Plasmodium vivax, rely on two distinct host cell surface proteins, CD81 and the Scavenger Receptor BI (SR-BI), respectively, to infect hepatocytes...
May 16, 2017: ELife
https://www.readbyqxmd.com/read/28493856/cdc-grand-rounds-public-health-strategies-to-prevent-and-treat-strokes
#10
Mary G George, Leah Fischer, Walter Koroshetz, Cheryl Bushnell, Michael Frankel, Jennifer Foltz, Phoebe G Thorpe
Worldwide, stroke is the second leading cause of death and a leading cause of serious long-term disability. In the United States, nearly 800,000 strokes occur each year; thus stroke is the fifth leading cause of death overall and the fourth leading cause of death among women (1). Major advances in stroke prevention through treatment of known risk factors has led to stroke being considered largely preventable. For example, in the United States, stroke mortality rates have declined 70% over the past 50 years, in large part because of important reductions in hypertension, tobacco smoking, and more recently, increased use of anticoagulation for atrial fibrillation (2,3)...
May 12, 2017: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/28483095/are-burnout-prevention-programs-for-hospital-physicians-needed
#11
Shabbir Amanullah, Kathie McNally, Jenni Zelin, Julie Cole, Zack Cernovsky
INTRODUCTION: Burnout, whether as a brief episode or more protracted, affects all aspects of a physician's life. Given the critical role of physicians in society, efforts to monitor, preserve, and enhance physician health are beneficial also to their patients. We investigated the patterns of burnout in physicians. METHODOLOGY: Maslach Burnout Inventory (MBI), in the General Survey version, was handed out to interested physicians of a Canadian general hospital in a Grand Rounds lecture on "well-being of physicians...
April 2017: Asian Journal of Psychiatry
https://www.readbyqxmd.com/read/28481707/immune-checkpoint-blockade-in-metastatic-urothelial-cancer
#12
Arjun Vasant Balar
The Oncology Grand Rounds series is designed to place original reports published in the Journal into clinical context. A case presentation is followed by a description of diagnostic and management challenges, a review of the relevant literature, and a summary of the authors' suggested management approaches. The goal of this series is to help readers better understand how to apply the results of key studies, including those published in Journal of Clinical Oncology, to patients seen in their own clinical practice...
May 8, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28481705/breast-reconstruction-with-postmastectomy-radiation-choices-and-tradeoffs
#13
Matthew M Poppe, Jayant P Agarwal
The Oncology Grand Rounds series is designed to place original reports published in the Journal into clinical context. A case presentation is followed by a description of diagnostic and management challenges, a review of the relevant literature, and a summary of the authors' suggested management approaches. The goal of this series is to help readers better understand how to apply the results of key studies, including those published in Journal of Clinical Oncology, to patients seen in their own clinical practice...
May 8, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28473787/individual-characteristics-vs-experience-an-experimental-study-on-cooperation-in-prisoner-s-dilemma
#14
Iván Barreda-Tarrazona, Ainhoa Jaramillo-Gutiérrez, Marina Pavan, Gerardo Sabater-Grande
Cooperative behavior is often assumed to depend on individuals' characteristics, such as altruism and reasoning ability. Evidence is mixed about what the precise impact of these characteristics is, as the subjects of study are generally randomly paired, generating a heterogeneous mix of the two characteristics. In this study we ex-ante create four different groups of subjects by factoring their higher or lower than the median scores in both altruism and reasoning ability. Then we use these groups in order to analyze the joint effect of the two characteristics on the individual choice of cooperating and on successful paired cooperation...
2017: Frontiers in Psychology
https://www.readbyqxmd.com/read/28470131/implementation-strategies-for-guidelines-at-icus-a-systematic-review
#15
Portia Jordan, Ferestas Mpasa, Wilma Ten Ham-Baloyi, Candice Bowers
Purpose The purpose of this paper is to critically analyze empirical studies related to the implementation strategies for clinical practice guidelines (CPGs) in intensive care units (ICUs). Design/methodology/approach A systematic review with a narrative synthesis adapted from Popay et al.'s method for a narrative synthesis was conducted. A search using CINAHL, Google Scholar, Academic search complete, Cochrane Register for Randomized Controlled Trials, MEDLINE via PUBMED and grey literature was conducted in 2014 and updated in 2016 (August)...
May 8, 2017: International Journal of Health Care Quality Assurance
https://www.readbyqxmd.com/read/28448239/extranodal-marginal-zone-lymphoma-no-longer-just-a-sidekick
#16
Manali K Kamdar, Sonali M Smith
The Oncology Grand Rounds series is designed to place original reports published in the Journal into clinical context. A case presentation is followed by a description of diagnostic and management challenges, a review of the relevant literature, and a summary of the authors' suggested management approaches. The goal of this series is to help readers better understand how to apply the results of key studies, including those published in Journal of Clinical Oncology, to patients seen in their own clinical practice...
June 10, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28437214/speaker-introductions-at-internal-medicine-grand-rounds-forms-of-address-reveal-gender-bias
#17
Julia A Files, Anita P Mayer, Marcia G Ko, Patricia Friedrich, Marjorie Jenkins, Michael J Bryan, Suneela Vegunta, Christopher M Wittich, Melissa A Lyle, Ryan Melikian, Trevor Duston, Yu-Hui H Chang, Sharonne N Hayes
BACKGROUND: Gender bias has been identified as one of the drivers of gender disparity in academic medicine. Bias may be reinforced by gender subordinating language or differential use of formality in forms of address. Professional titles may influence the perceived expertise and authority of the referenced individual. The objective of this study is to examine how professional titles were used in the same and mixed-gender speaker introductions at Internal Medicine Grand Rounds (IMGR). METHODS: A retrospective observational study of video-archived speaker introductions at consecutive IMGR was conducted at two different locations (Arizona, Minnesota) of an academic medical center...
February 16, 2017: Journal of Women's Health
https://www.readbyqxmd.com/read/28409289/expert-s-comment-concerning-grand-rounds-case-entitled-acute-complete-paraplegia-of-a-8-year-old-girl-caused-by-spinal-cord-infarction-following-minor-trauma-complicated-with-longitudinal-signal-change-of-spinal-cord-by-k-nagata-et-al-eur-spine-j-2017-doi-10
#18
https://www.readbyqxmd.com/read/28394064/adapting-academic-tradition-to-cultivate-leaders-medical-student-grand-rounds
#19
Daniel B Nelson, Erika Y Rekoumis, Andrew R Barnosky, Rajesh S Mangrulkar
No abstract text is available yet for this article.
May 2017: Medical Education
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
#20
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
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