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Leticia Leon, Luis Rodriguez-Rodriguez, Maria Dolores Aguilar, Juan Ángel Jover, Cristina Vadillo, Marta Redondo, Lydia Abasolo
OBJECTIVE: The aim of this study was to assess the reliability and validity of the Spanish version of the Rosser classification system for disease states in patients with musculoskeletal disorders. METHODS: Our study was based on a questionnaire validation design. Patients were attended at an outpatient rheumatology clinic at Hospital Clínico San Carlos, Madrid, Spain. The Rosser classification system was completed by the physician from the research team (PMQ) and by the patient (HMQ)...
March 21, 2018: Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases
Darius M Moshfeghi
PURPOSE OF REVIEW: This review highlights the common areas of medicolegal risk during retinopathy of prematurity (ROP) screening. RECENT FINDINGS: Most malpractice risk in ROP comes from systemic errors that ultimately result in failure to screen the patient in a timely fashion, resulting in failures to intervene and/or refer in a timely fashion. Currently, the emphasis is engaging the family members, the hospital staff, and clinic staff to pro-actively manage ROP patients and ensure that they are screened in a timely fashion...
March 20, 2018: Current Opinion in Ophthalmology
Wolf Osterode, Sandra Schranz, Galateja Jordakieva
Mental and physical stress is common in physicians during night shifts. Neurocognitive effects of sleep deprivation as well as alterations in hormonal and metabolic parameters have previously been described. The aim of this crossover study was to evaluate the effects of night-shift work with partial sleep deprivation on steroid hormone excretion and possible associations with mood, sleep characteristics and cognitive functions in physicians. In total, 34 physicians (mean age 42 ± 8.5 years, 76.5% male) from different departments of the General Hospital of Vienna, Austria, were randomly assigned to two conditions: a regular day shift (8 h on duty, condition 1) and a continuous day-night shift (24 h on duty, condition 2)...
March 21, 2018: Chronobiology International
Leos Landa, Jan Jurica, Jiri Sliva, Monika Pechackova, Regina Demlova
The use of cannabis for medical purposes has been recently legalised in many countries including the Czech Republic. As a result, there is increased interest on the part of physicians and patients in many aspects of its application. This mini review briefly covers the main active substances of the cannabis plant and mechanisms of action. It focuses on two conditions, cancer pain and spasticity in multiple sclerosis, where its effects are well-documented. A comprehensive overview of a few cannabis-based products and the basic pharmacokinetics of marijuana's constituents follows...
March 19, 2018: Biomedical Papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia
Y Sasabuchi, H Yasunaga, H Matsui, A K Lefor, K Fushimi, M Sanui
BACKGROUNDS AND AIMS: Epidural analgesia is an option for pain control in patients with acute pancreatitis. The aim of this study is to describe characteristics, morbidity and mortality of patients with acute pancreatitis treated with epidural analgesia. PATIENTS AND METHODS: Data was extracted from a national inpatient database in Japan on patients hospitalized with acute pancreatitis between July 2010 and March 2013. A total of 44,146 patients discharged from acute care hospitals were included in this retrospective cohort study...
July 2017: Acta Gastro-enterologica Belgica
Sarah Ziegler, Margareta Schmid, Matthias Bopp, Georg Bosshard, Milo Alan Puhan
BACKGROUND: In the last decade, the number of patients continuously deeply sedated until death increased up to fourfold. The reasons for this increase remain unclear. OBJECTIVE: To identify socio-demographic and clinical characteristics of sedated patients, and concurrent possibly life-shortening medical end-of-life decisions. DESIGN: Cross-sectional death certificate study in German-speaking Switzerland in 2001 and 2013. PARTICIPANTS: Non-sudden and expected deaths (2001: N = 2281, 2013: N = 2256) based on a random sample of death certificates and followed by an anonymous survey on end-of-life practices among attending physicians...
March 20, 2018: Journal of General Internal Medicine
Maryam Hassanzad, Azam Orooji, Ali Valinejadi, Aliakbar Velayati
Background: Finding a valid diagnosis is mostly a prolonged process. Current advances in the sector of artificial intelligence have led to the appearance of expert systems that enrich the experiences and capabilities of doctors for making decisions for their patients. Objective: The objective of this research was developing a fuzzy expert system for diagnosing Cystic Fibrosis (CF). Methods: Defining the risk factors and then, designing the fuzzy expert system for diagnosis of CF were carried out in this cross-sectional study...
December 2017: Electronic Physician
Joshua Brown, Jeffery Talbert, Ryan Pennington, Qiong Han, Driss Raissi
Background: Retrieval of inferior vena cava filters (IVCFs) is important to decrease the long-term risk of complications associated with indwelling devices. Our hospital experienced low retrieval rates and implemented a low-cost intervention and evaluation for quality improvement. The working hypothesis was that a simple, mailed letter intervention could increase retrieval rates by increasing patient and primary care provider knowledge of the need for retrieval. Methods: For all prospective patients who received a retrievable IVCF during the intervention period from January 1, 2014 to February 29, 2016, patients and their primary care providers were mailed letters encouraging contact with the clinic for evaluation of eligibility for retrieval...
2018: Patient Safety in Surgery
Po-Ya Chang, Li-Nien Chien, Chyi-Huey Bai, Yuh-Feng Lin, Hung-Yi Chiou
Purpose: Effective management for type 2 diabetes mellitus (DM) can slow the progression of kidney outcomes and reduce hospital admissions. Better continuity of care (COC) was found to improve patients' adherence and self-management. This study examined the associations between COC, hospitalization, and end-stage renal disease (ESRD) in DM patients. Patients and methods: In the cohort study, data from 1996 to 2012 were retrieved from the Longitudinal Health Insurance Database, using inverse probability weighted analysis...
2018: Therapeutics and Clinical Risk Management
Matthew W Zackoff, Camille Graham, Denise Warrick, Kathleen Pulda, Craig Gosdin, Blair Simpson, Jessica Marischen, Paul Bunch, Michael Vossmeyer, Grant M Mussman
OBJECTIVES: During hospital admission, communication between primary care physicians (PCPs) and hospital medicine (HM) physicians provides an opportunity for collaboration. Two-way communication facilitates collaboration by allowing the receiver to ask and respond to questions. At our institution, most HM-to-PCP communication occurred by telephone call after discharge. Our specific aim was to increase the percentage of patients for whom a telephone conversation occurred between HM and PCPs during hospital admission from 40% to >80%...
March 20, 2018: Hospital Pediatrics
Jared Brazg, Phyllis Huang, Corey Weiner, Guneet Singh, Antonios Likourezos, Linda Salem, Eitan Dickman, John Marshall
IMPORTANCE: Emergency Physicians often rely on Lactic Acid (LA) values to make important clinical decisions. Accuracy of LA values improve when blood gas analysis is performed in the emergency department (ED) as opposed to a satellite laboratory (SL). OBJECTIVE: To investigate an association between blood gas laboratory location and accuracy of ED lactic acid samples. METHODS: The study team evaluated lactic acid values from venous and arterial blood gas samples drawn between June 1, 2015 and September 30, 2016...
March 12, 2018: American Journal of Emergency Medicine
Anthony J Scholer, Munim Ali Khan, Aastha Tandon, Kenneth Swan, Ravi J Chokshi
In today's medical community, when people say the name Herman Boerhaave, most assimilate it to Boerhaave syndrome. His influence on medicine is seen every day in hospitals around the world. His methodologies revolutionized medical education and the way physicians approach the examination of patients. It has been said that during the Age of Reason, he was the "Bearer of the Enlightenment of Medicine." He is a forgotten father of medicine. To preserve medical history, educators should give students a brief summary of the contributors to medicine to remind us how much of their lives they gave to further medical knowledge...
March 1, 2018: American Surgeon
Meghann McKane, Debra A Dodd, Bret A Mettler, Kari A Wujcik, Justin Godown
BACKGROUND: Many pediatric heart transplant recipients live a significant distance from their transplant center. This results in families either traveling long distances or relying on outside physicians to assume aspects of their care. Distance has been implicated to play a role in congenital heart disease outcomes, but its impact on heart transplantation has not been reported. The aim of this study was to assess the impact of distance on pediatric heart transplant outcomes. METHODS: The Scientific Registry of Transplant Recipients database was queried for all pediatric heart transplant recipients from large US children's hospitals (1987-2014)...
January 1, 2018: Progress in Transplantation
Donna Koller, Sherry Espin
Despite the prevalence of medical errors in pediatrics, little research examines stakeholder perspectives on the disclosure of adverse events, particularly in the case of children's own perspectives. Stakeholder perspectives, however, are integral to informing processes for pediatric disclosure. Building on a systematic review of the literature, this article presents findings from a series of focus groups with key pediatric stakeholders where perspectives were sought on the disclosure of medical errors. Focus groups were conducted with three stakeholder groups...
January 1, 2018: Journal of Child Health Care: for Professionals Working with Children in the Hospital and Community
Christine Huynh, Darci Bowles, Miao-Shan Yen, Allison Phillips, Rachel Waller, Lindsey Hall, Shin-Ping Tu
Adaptive Reserve (AR) is positively associated with implementing change in ambulatory settings. Deficits in AR may lead to change fatigue or burnout. We studied the association of self-reported AR and burnout among providers to hospitalized medicine patients in an academic medical center. An electronic survey containing a 23-item Adaptive Reserve scale, burnout inventory, and demographic questions was sent to a convenience sample of nurses, house staff team members, and hospitalists. A total of 119 self-administered, online surveys collected from June 2014 to March 2015 were analyzed...
March 20, 2018: Journal of Interprofessional Care
Alessandro di Luca, Giuseppe Vetrugno, Vincenzo Lorenzo Pascali, Antonio Oliva, Al Ozonoff
OBJECTIVES: Italy is experiencing a crisis of malpractice litigation with important repercussions on the insurance industry (e.g., lower profits), physicians (e.g., defensive medicine), and the courts (e.g., work backlog, lengthy proceedings). We searched for common ground between legal systems in Italy and the United States and considered the implications for international collaborations in patient safety. METHODS: We examined the judicial frameworks of medical malpractice litigation in two countries with different legal foundations: the United States (a public-private system governed by common law) and Italy (a publicly financed healthcare system governed by civil law)...
March 19, 2018: Journal of Patient Safety
Lina H Al-Sakran, Ruth Ann Marrie, David F Blackburn, Katherine B Knox, Charity D Evans
OBJECTIVE: To validate a case definition of multiple sclerosis (MS) using health administrative data and to provide the first province-wide estimates of MS incidence and prevalence for Saskatchewan, Canada. METHODS: We used population-based health administrative data between January 1, 1996 and December 31, 2015 to identify individuals with MS using two potential case definitions: (1) ≥3 hospital, physician, or prescription claims (Marrie definition); (2) ≥1 hospitalization or ≥5 physician claims within 2 years (Canadian Chronic Disease Surveillance System [CCDSS] definition)...
March 20, 2018: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
Maurits Boon, Colin Huntley, Armin Steffen, Joachim T Maurer, J Ulrich Sommer, Richard Schwab, Erica Thaler, Ryan Soose, Courtney Chou, Patrick Strollo, Eric J Kezirian, Stanley Chia, Kirk Withrow, Mark Weidenbecher, Kingman Strohl, Karl Doghramji, Benedikt Hofauer, Clemens Heiser
Objective Upper airway stimulation (UAS) is an alternative treatment option for patients unable to tolerate continuous positive airway pressure (CPAP) for the treatment of obstructive sleep apnea (OSA). Studies support the safety and efficacy of this therapy. The aim of this registry is to collect retrospective and prospective objective and subjective outcome measures across multiple institutions in the United States and Germany. To date, it represents the largest cohort of patients studied with this therapy...
March 1, 2018: Otolaryngology—Head and Neck Surgery
Robert J Morrison, Kelly M Malloy, Rishi R Bakshi
Objective To assess the impact of implementation of a "1-step" documentation query system on comorbidity capture and quality outcomes within the Department of Otolaryngology-Head and Neck Surgery. Methods Implementation of the 1-step documentation query system was instituted for all otolaryngology-head and neck surgery faculty at a single institution. Individual query responses and impact metrics were analyzed. Departmental case-mix index (CMI), risk of mortality (ROM), and severity of illness (SOI) were collated over a 14-month implementation period and compared to a 12-month preimplementation period...
March 1, 2018: Otolaryngology—Head and Neck Surgery
Wasim Khasawneh, Salar Bani Hani
Medication errors remain among the major problems seen in hospitals. Such errors can relate to the prescription, dispensation, or administration of drugs. Human factors account for most of these mistakes, but other factors such as infusion pump programming defects should always be considered. Worldwide, medication errors have been reported to affect 2-30% of patients, depending on the institution. Intravenous lipid emulsion (ILE) infusion is frequently used as part of total parenteral nutrition in patients of all ages with feeding and gastrointestinal issues...
March 19, 2018: Drug Safety—Case Reports
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