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https://www.readbyqxmd.com/read/29784051/contributions-of-a-survey-and-retrospective-cohort-study-to-the-planning-of-a-randomised-controlled-trial-of-corticosteroids-in-the-treatment-of-paediatric-septic-shock
#1
Anna Liu, Kusum Menon
BACKGROUND: Randomised controlled trials (RCTs) are challenging to conduct in a paediatric critical-care environment. Background work, including surveys and observational studies, is often used to determine disease estimates, sample sizes and design protocols when planning such RCTs. Our objective was to determine the necessity of performing a survey or a retrospective chart review or both when planning an RCT on corticosteroids in the treatment of paediatric septic shock. METHODS: We compared information on corticosteroid use for moderate to severe paediatric septic shock obtained from a survey of physician beliefs and stated practices with that obtained from a retrospective cohort study...
May 21, 2018: Trials
https://www.readbyqxmd.com/read/29782642/tofacitinib-in-patients-with-moderate-to-severe-chronic-plaque-psoriasis-long-term-safety-and-efficacy-in-an-open-label-extension-study
#2
F Valenzuela, N J Korman, R Bissonnette, N Bakos, T-F Tsai, M K Harper, W C Ports, H Tan, A Tallman, H Valdez, A C Gardner
BACKGROUND: Tofacitinib is an oral Janus kinase inhibitor. Final safety and efficacy data from an open-label extension study of tofacitinib in psoriasis are reported. OBJECTIVE: To evaluate the long-term safety and durability of efficacy of tofacitinib in adults with moderate to severe chronic plaque psoriasis. METHODS: Eligible patients who completed qualifying Phase 2/3 tofacitinib studies received tofacitinib 10 mg twice daily (BID) until Month 3; subsequently, the dose could be adjusted by investigators to either 5 or 10 mg BID...
May 21, 2018: British Journal of Dermatology
https://www.readbyqxmd.com/read/29779089/duration-of-opening-statement-of-patients-attending-a-chronic-pain-clinic-consultation
#3
Ather Imran, Deepak Doltani, Jean Saunders, Dominic Harmon
BACKGROUND: The opening patient statement is an important part of the medical consultation. It is where after the initial solicitation the physician gets information about the patient's current problems and concerns. Previous research shows that 23-28% of patients are allowed to complete their opening statement un-interruptedly in the general practice setting. Interruption results in fewer patient concerns expressed and failure to gather potentially important patient information. OBJECTIVES: The objective of the study was to assess the duration of opening statements of patients attending a chronic pain clinic consultation...
May 19, 2018: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/29771749/brillouin-microscopy-assessing-ocular-tissue-biomechanics
#4
Seok Hyun Yun, Dimitri Chernyak
PURPOSE OF REVIEW: Assessment of corneal biomechanics has been an unmet clinical need in ophthalmology for many years. Many researchers and clinicians have identified corneal biomechanics as source of variability in refractive procedures and one of the main factors in keratoconus. However, it has been difficult to accurately characterize corneal biomechanics in patients. The recent development of Brillouin light scattering microscopy heightens the promise of bringing biomechanics into the clinic...
May 15, 2018: Current Opinion in Ophthalmology
https://www.readbyqxmd.com/read/29762798/a-prenatal-standardized-patient-experience-for-medical-students-on-their-family-medicine-clerkship
#5
Sarah E Stumbar, Suzanne Minor, Marquita Samuels
BACKGROUND AND OBJECTIVES: Students on their family medicine clerkship at Herbert Wertheim College of Medicine get little clinical exposure to obstetric care, which is not commonly provided by family physicians in urban settings. To address this, we added to our clerkship didactic curriculum a 2-hour session involving a standardized patient (SP). The SP is collectively interviewed by the student group during four simulated prenatal visits, each of which present a different complication of pregnancy...
May 2018: Family Medicine
https://www.readbyqxmd.com/read/29760862/free-open-access-medical-education-foam-in-emergency-medicine-the-global-distribution-of-users-in-2016
#6
Taylor W Burkholder, Jennifer W Bellows, Renee A King
Introduction: Free open-access medical education (FOAM) is a collection of interactive online medical education resources-free and accessible to students, physicians and other learners. This novel approach to medical education has the potential to reach learners across the globe; however, the extent of its global uptake is unknown. Methods: This descriptive report evaluates the 2016 web analytics data from a convenience sample of FOAM blogs and websites with a focus on emergency medicine (EM) and critical care...
May 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29758323/why-do-vascular-surgeons-get-sued-analysis-of-claims-and-outcomes-in-malpractice-litigation
#7
John Phair, Eric B Trestman, Eddie Skripochnik, Evan C Lipsitz, Issam Koleilat, Larry A Scher
OBJECTIVE: To analyze causes and outcomes of malpractice claims against vascular surgeons in the United States. METHODS: Cases entered into the Westlaw database from January 1st 1999 to December 31st 2014 were reviewed. Search terms "vascular" and "surgeon" were used. Data was compiled on the allegation, subject matter and outcome of each case. Additional data including demographics of the defendant was obtained from U.S. News Health Reports on practicing physicians...
May 11, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29747630/reflection-revisited-how-physicians-conceptualize-and-experience-reflection-in-professional-practice-a-qualitative-study
#8
Elisa Bindels, Christel Verberg, Albert Scherpbier, Sylvia Heeneman, Kiki Lombarts
BACKGROUND: For the purpose of continuous performance improvement, physicians are expected to reflect on their practice. While many reflection studies are theoretically oriented and often prescriptive in the sense that they conceptualize what reflection should look like, the current study starts with practicing physicians themselves and maps how these physicians conceptualize and experience reflection in daily professional practice. METHODS: We conducted a qualitative study using in-depth interviews with 13 hospital-based physicians from various specialties and institutions...
May 11, 2018: BMC Medical Education
https://www.readbyqxmd.com/read/29735302/a-physician-led-initiative-to-improve-clinical-documentation-results-in-improved-health-care-documentation-case-mix-index-and-increased-contribution-margin
#9
Francesco A Aiello, Dejah R Judelson, Jonathan M Durgin, Danielle R Doucet, Jessica P Simons, Dawn M Durocher, Julie M Flahive, Andres Schanzer
INTRODUCTION: Clinical documentation is the key determinant of inpatient acuity of illness and payer reimbursement. Every inpatient hospitalization is placed into a diagnosis related group with a relative value based on documented procedures, conditions, comorbidities and complications. The Case Mix Index (CMI) is an average of these diagnosis related groups and directly impacts physician profiling, medical center profiling, reimbursement, and quality reporting. We hypothesize that a focused, physician-led initiative to improve clinical documentation of vascular surgery inpatients results in increased CMI and contribution margin...
May 4, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29728521/financial-relationships-between-neurologists-and-industry-the-2015-open-payments-database
#10
Aditi Ahlawat, Pushpa Narayanaswami
OBJECTIVE: To analyze research and nonresearch payments from the pharmaceutical and device industry to neurologists in 2015 using the Centers for Medicare and Medicaid Services (CMS) Open Payments database. METHODS: In this retrospective database analysis, we computed the percentage of neurologists in the United States receiving payments, the median/mean payments per neurologist, payment categories, regional trends, and sponsors. We computed the number of practicing neurologists from the Association of American Medical Colleges State Physician Workforce data book, 2015...
May 4, 2018: Neurology
https://www.readbyqxmd.com/read/29722886/usefulness-of-routine-computed-tomography-in-the-evaluation-of-penetrating-war-injuries-to-the-chest
#11
Bassam Darwish, Mohammad Z Mahfouz, Mohammad Bashar Izzat
OBJECTIVES: This review was conducted to compare the contributions of chest X-ray (CXR) and computed tomography (CT) towards detecting intrathoracic damage in patients with penetrating war injuries to the chest and to determine whether identification of additional injuries by chest CT will have an impact on the choice of therapeutic interventions and clinical outcomes. METHODS: We reviewed records of 449 patients (374 men, mean age 29.3 ± 14.8 years) who were admitted to our hospital with penetrating war injuries to the chest over a 7-year period...
May 2, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29716607/internal-migration-of-physicians-who-graduated-in-brazil-between-1980-and-2014
#12
Mario Cesar Scheffer, Alex Jones Flores Cassenote, Aline Gil Alves Guilloux, Mario Roberto Dal Poz
BACKGROUND: The internal migration of physicians from one place to another in the same country can unbalance the supply and distribution of these professionals in national health systems. In addition to economic, social and demographic issues, there are individual and professional factors associated with a physician's decision to migrate. In Brazil, there is an ongoing debate as to whether opening medicine programmes in the interior of the country can induce physicians to stay in these locations...
May 2, 2018: Human Resources for Health
https://www.readbyqxmd.com/read/29706473/procedural-and-perioperative-results-in-patients-treated-with-fenestrated-endovascular-aneurysm-repair-planned-by-automated-software-in-a-physician-sponsored-investigational-device-exemption-trial-of-physician-modified-endografts
#13
Benjamin W Starnes, Billi Tatum, Niten Singh
OBJECTIVE: Fenestrated endovascular aneurysm repair (FEVAR) has been used successfully to treat patients with juxtarenal abdominal aortic aneurysms (JAAAs). Barriers to wide adoption of FEVAR include complexity in planning of fenestration locations on endografts. The purpose of this study was to validate the use of automated planning software to design fenestrated endografts and to treat patients with complex abdominal aortic aneurysms. METHODS: Patients with JAAA who were not candidates for open repair were enrolled into the automated planning arm of an ongoing investigational device exemption clinical trial and treated with FEVAR...
April 26, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29704979/improving-emergency-health-care-workers-knowledge-competency-and-attitudes-toward-lesbian-gay-bisexual-and-transgender-patients-through-interdisciplinary-cultural-competency-training
#14
Sarah Bristol, Teresa Kostelec, Ryan MacDonald
INTRODUCTION: Emergency staff members have a unique role in providing episodic care to marginalized populations. The lesbian, gay, bisexual, and transgender (LGBT) community is a marginalized population that is routinely encountered by ED staff. Implicit prejudice may influence emergency staff interactions and contribute to distrust of health care providers by some members of the LGBT community. The purpose of our study is to evaluate aggregate ED health care team member's knowledge and attitudes toward lesbian, gay, bisexual, and transgender people pre- and post-cultural competency training education...
April 25, 2018: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/29687753/cleaning-up-the-paper-trail-our-clinical-notes-in-open-view
#15
Gerard Lambe, Niall Linnane, Ian Callanan, Marcus W Butler
Purpose Ireland's physicians have a legal and an ethical duty to protect confidential patient information. Most healthcare records in Ireland remain paper based, so the purpose of this paper is to: assess the protection afforded to paper records; log highest risk records; note the variations that occurred during the working week; and observe the varying protection that occurred when staff, students and public members were present. Design/methodology/approach A customised audit tool was created using Sphinx software...
April 16, 2018: International Journal of Health Care Quality Assurance
https://www.readbyqxmd.com/read/29680480/the-receipt-of-industry-payments-is-associated-with-prescribing-promoted-alpha-blockers-and-overactive-bladder-medications
#16
Parth K Modi, Ye Wang, Peter S Kirk, James M Dupree, Eric A Singer, Steven L Chang
OBJECTIVE: To determine the impact of physicians' financial relationships with the pharmaceutical industry on prescribing marketed alpha-blockers and overactive bladder medications. We also aim to examine if the number or total value of transactions is influential. MATERIALS AND METHODS: We linked the Open Payments Program database of industry payments to prescribers with Medicare Part D prescription data. We used binomial logistic regression to identify the association between receipt of industry payment and prescribing of marketed alpha-blockers (silodosin) and overactive bladder (OAB) medications (fesoterodine, solifenacin, and mirabegron)...
April 19, 2018: Urology
https://www.readbyqxmd.com/read/29669146/impact-of-scribes-on-medical-student-education-a-mixed-methods-pilot-study
#17
Julia Hafer, Xibin Wu, Steven Lin
BACKGROUND AND OBJECTIVES: Medical scribes are an increasingly popular strategy for reducing clerical burden, but little is known about their effect on medical student education. We aimed to evaluate the impact of scribes on medical students' self-reported learning experience. METHODS: We conducted a mixed-methods pilot study. Participants were medical students (third and fourth years) on a family medicine clerkship who worked with an attending physician who practiced with a scribe...
April 2018: Family Medicine
https://www.readbyqxmd.com/read/29665190/comparison-of-emergency-medicine-malpractice-cases-involving-residents-to-non-resident-cases
#18
Kiersten L Gurley, Shamai A Grossman, Margaret Janes, C Winnie Yu-Moe, Ellen Song, Carrie D Tibbles, Nathan I Shapiro, Carlo L Rosen
BACKGROUND: Data are lacking on how emergency medicine (EM) malpractice cases with resident involvement differs from cases that do not name a resident. OBJECTIVES: To compare malpractice case characteristics in cases where a resident is involved (resident case) to cases that do not involve a resident (non-resident case) and to determine factors that contribute to malpractice cases utilizing EM as a model for malpractice claims across other medical specialties. METHODS: We used data from the Controlled Risk Insurance Company (CRICO) Strategies' division Comparative Benchmarking System (CBS) to analyze open and closed EM cases asserted from 2009-2013...
April 17, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29664860/conflict-of-interest-disclosures-to-the-journal-of-bone-joint-surgery-the-relevance-of-industry-reported-payments
#19
Michael C Fu, Venkat Boddapati, Benedict U Nwachukwu, Anil S Ranawat, Todd J Albert, Joshua S Dines
BACKGROUND: Academic journals such as The Journal of Bone & Joint Surgery (JBJS) require disclosures of financial relationships that authors report as potential conflicts of interest. Because industry payments can take various forms, including food and beverage, consulting, or research payments, the purpose of this study was to determine which categories of industry-reported payments were most frequently considered by authors as irrelevant to their specific publication, and therefore not included in their journal disclosures...
April 18, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29650747/patient-centred-primary-care-of-adults-with-severe-and-profound-intellectual-and-developmental-disabilities-patient-caregiver-physician-relationship
#20
Katherine Stringer, Amanda L Terry, Bridget L Ryan, Andrea Pike
OBJECTIVE: To explore the process of the development of the patient-physician relationship in adult patients with severe or profound intellectual and developmental disabilities (IDD), from the perspective of the patients' caregivers. DESIGN: Constructivist grounded theory. SETTING: St John's, NL. PARTICIPANTS: Thirteen primary caregivers (5 males, 8 females) of 1 or more adults with severe or profound IDD. METHODS: Data were collected via in-depth, semistructured interviews conducted in person or by telephone...
April 2018: Canadian Family Physician Médecin de Famille Canadien
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