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https://www.readbyqxmd.com/read/27913839/the-ability-of-emergency-physicians-to-diagnose-and-score-acute-pancreatitis-on-computed-tomography
#1
A Karagöz, E E Ünlüer, O Oyar, F E Topal, F Topal
PURPOSE: The aim of this study is to determine the ability of emergency physicians' (EP) interpreting contrast-enhanced computed tomographies (CECTs) performed in patients diagnosed or suspected acute pancreatitis (AP), using the modified computed tomography severity index (MCTSI) scoring system. METHODS: This study was conducted in Training and Research Hospital's Emergency Department. From January 1, 2013 to April 30, 2016, patients whom performed CECT within 24 h of admission with diagnosis or suspicion of AP were reviewed retrospectively...
December 2, 2016: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/27908493/diagnostic-accuracy-of-the-kampala-trauma-score-using-estimated-abbreviated-injury-scale-scores-and-physician-opinion
#2
Andrew Gardner, Paa Kobina Forson, George Oduro, Barclay Stewart, Nkechi Dike, Paul Glover, Ronald F Maio
BACKGROUND: The Kampala Trauma Score (KTS) has been proposed as a triage tool for use in low- and middle-income countries (LMICs). This study aimed to examine the diagnostic accuracy of KTS in predicting emergency department outcomes using timely injury estimation with Abbreviated Injury Scale (AIS) score and physician opinion to calculate KTS scores. METHODS: This was a diagnostic accuracy study of KTS among injured patients presenting to Komfo Anokye Teaching Hospital A&E, Ghana...
November 21, 2016: Injury
https://www.readbyqxmd.com/read/27870675/comanagement-and-gainsharing-opportunities-for-independent-physicians
#3
Chris McBride, Peter L Althausen
Gainsharing and comanagament programs are both successful means of achieving physician buy-in for all cost containment programs in Orthopaedic Trauma. Under comanagement agreements, physicians are reimbursed for their time and intellectual efforts in program and algorithm creation. The cost is minimal for the hospital in return for the millions of dollars in savings they achieve. Gainsharing models can incentivize physicians to quickly adopt cost-effective implant choices, care plans, and program development...
December 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27870673/financial-impact-of-dual-vendor-matrix-pricing-and-sole-source-contracting-on-implant-costs
#4
Peter L Althausen, Joan Lapham, Lisa Mead
Implant costs comprise the largest proportion of operating room supply costs for orthopedic trauma care. Over the years, hospitals have devised several methods of controlling these costs with the help of physicians. With increasing economic pressure, these negotiations have a tremendous ability to decrease the cost of trauma care. In the past, physicians have taken no responsibility for implant pricing which has made cost control difficult. The reasons have been multifactorial. However, industry surgeon consulting fees, research support, and surgeon comfort with certain implant systems have played a large role in slowing adoption of cost-control measures...
December 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27864915/identification-of-emergency-department-visits-in-medicare-administrative-claims-approaches-and-implications
#5
Arjun K Venkatesh, Hao Mei, Keith Kocher, Mike Granovsky, Ziad Obermeyer, Erica Spatz, Craig Rothenberg, Harlan Krumholz, Zhenqui Lin
OBJECTIVES: Administrative claims datasets are often used for emergency care research and policy investigations of healthcare resource utilization, acute care practices, and evaluation of quality improvement interventions. Despite the high profile of emergency department (ED) visits in analyses using administrative claims, little work has evaluated the degree to which existing definitions based on claims data accurately captures conventionally defined hospital-based ED services. We sought to construct an operational definition for ED visitation using a comprehensive Medicare dataset and to compare this definition to existing operational definitions used by researchers and policymakers...
November 19, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/27858686/inter-rater-reliability-of-diagnostic-criteria-for-sacroiliac-joint-disc-and-facet-joint-pain
#6
Cornelis W J van Tilburg, Johannes G Groeneweg, Dirk L Stronks, Frank J P M Huygen
BACKGROUND/OBJECTIVE: Several diagnostic criteria sets are described in the literature to identify low back pain subtypes, but very little is known about the inter-rater reliability of these criteria. We conducted a study to determine the reliability of diagnostic tests that point towards SI joint-, disc- or facet joint pain. METHODS: Inter-rater reliability study alongside three randomized clinical trials. Multidisciplinary pain center of general hospital. Patients aged 18 or more with medical history and physical examination suggestive of sacroiliac joint-, disc- and facet joint pain on lumbar level...
November 18, 2016: Journal of Back and Musculoskeletal Rehabilitation
https://www.readbyqxmd.com/read/27846440/evaluation-of-human-papillomavirus-detection-by-abbott-m2000-system-on-samples-collected-by-fta-elute%C3%A2-card-in-a-chinese-hiv-1-positive-population
#7
Yu Qin, Hongyun Zhang, Natalia Marlowe, Mandong Fei, Judy Yu, Xiaoqin Lei, Lulu Yu, Jia Zhang, Di Cao, Li Ma, Wen Chen
BACKGROUND: HIV+/AIDS women have an increased risk of developing into CIN and cervical cancer compared to the general population. Limited medical resource and the lack of AIDS relevant knowledge impair the coverage and efficiency of cervical cancer screening. OBJECTIVES: To compare the clinical performance of self-collected dry storage medium (FTA Elute card) and physician-collected PreservCyt medium in detection of high risk human papillomavirus (HR HPV) among HIV-1 positive population...
November 9, 2016: Journal of Clinical Virology: the Official Publication of the Pan American Society for Clinical Virology
https://www.readbyqxmd.com/read/27843574/a-review-of-american-pharmacy-education-training-technology-and-practice
#8
REVIEW
Scott J Knoer, Allison R Eck, Amber J Lucas
In the United States, pharmacists are responsible for the provision of safe, effective, efficient, and accountable medication related-care for hospital and health-system patients. Leveraging automated technologies, pharmacy technicians, and pharmacist extenders are the means through which efficient, effective, and safe medication use processes are created and maintained. These strategies limit the amount of pharmacist resources needed for nonjudgmental tasks such as medication distribution, allowing more capacity for advanced direct patient care roles...
2016: Journal of Pharmaceutical Health Care and Sciences
https://www.readbyqxmd.com/read/27821141/knowledge-attitude-and-practice-of-healthcare-ethics-among-resident-doctors-and-ward-nurses-from-a-resource-poor-setting-nepal
#9
Samaj Adhikari, Kumar Paudel, Arja R Aro, Tara Ballav Adhikari, Bipin Adhikari, Shiva Raj Mishra
BACKGROUND: Healthcare ethics is neglected in clinical practice in LMICs (Low and Middle Income Countries) such as Nepal. The main objective of this study was to assess the current status of knowledge, attitude and practice of healthcare ethics among resident doctors and ward nurses in a tertiary teaching hospital in Nepal. METHODS: This was a cross sectional study conducted among resident doctors (n = 118) and ward nurses (n = 86) in the largest tertiary care teaching hospital of Nepal during January- February 2016 with a self-administered questionnaire...
November 8, 2016: BMC Medical Ethics
https://www.readbyqxmd.com/read/27811530/clinical-examination-does-not-predict-response-to-albuterol-in-ventilated-infants-with-bronchiolitis
#10
Craig M Schramm, Kathleen A Sala, Christopher L Carroll
OBJECTIVE: Bronchiolitis is a common respiratory infection in infants that is sometimes treated with albuterol. Response to albuterol is determined by clinical assessment, but this subjective determination is potentially unreliable. In this study, we compared providers' clinical assessment of response to albuterol with the measurement of response by pulmonary mechanics in intubated, sedated, and ventilated infants. DESIGN: Before and 20 minutes following racemic albuterol therapy, a nurse, respiratory therapist, and physician performed simultaneous examinations and assessed response to albuterol in a population of intubated infants with bronchiolitis...
November 1, 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27811140/hospital-ownership-of-physicians-hospital-versus-physician-perspectives
#11
Laurence C Baker, M Kate Bundorf, Aileen M Devlin, Daniel P Kessler
Although there has been significant interest from health services researchers and policy makers about recent trends in hospitals' ownership of physician practices, few studies have investigated the strengths and weaknesses of available data sources. In this article, we compare results from two national surveys that have been used to assess ownership patterns, one of hospitals (the American Hospital Association survey) and one of physicians (the SK&A survey). We find some areas of agreement, but also some disagreement, between the two surveys...
November 2, 2016: Medical Care Research and Review: MCRR
https://www.readbyqxmd.com/read/27750249/how-reliable-are-administrative-data-for-capturing-stroke-patients-and-their-care
#12
Joan Porter, Luke Mondor, Moira K Kapral, Jiming Fang, Ruth E Hall
BACKGROUND/AIMS: The reliability of diagnostic coding of acute stroke and transient ischemic attack (TIA) in administrative data is uncertain. The purpose of this study is to determine the agreement between administrative data sources and chart audit for the identification of stroke type, stroke risk factors, and the use of hospital-based diagnostic procedures in patients with stroke or TIA. METHODS: Medical charts for a population-based sample of patients (n = 14,508) with ischemic stroke, intracerebral hemorrhage (ICH), or TIA discharged from inpatient and emergency departments (ED) in Ontario, Canada, between April 1, 2012 and March 31, 2013, were audited by trained abstractors...
October 18, 2016: Cerebrovascular Diseases Extra
https://www.readbyqxmd.com/read/27733666/the-impacts-of-a-pharmacist-managed-outpatient-clinic-and-chemotherapy-directed-electronic-order-sets-for-monitoring-oral-chemotherapy
#13
Brandon Battis, Linda Clifford, Mostaqul Huq, Edrick Pejoro, Scott Mambourg
OBJECTIVES: Patients treated with oral chemotherapy appear to have less contact with the treating providers. As a result, safety, adherence, medication therapy monitoring, and timely follow-up may be compromised. The trend of treating cancer with oral chemotherapy agents is on the rise. However, standard clinical guidance is still lacking for prescribing, monitoring, patient education, and follow-up of patients on oral chemotherapy across the healthcare settings. The purpose of this project is to establish an oral chemotherapy monitoring clinic, to create drug and lab specific provider order sets for prescribing and lab monitoring, and ultimately to ensure safe and effective treatment of the veterans we serve...
October 12, 2016: Journal of Oncology Pharmacy Practice
https://www.readbyqxmd.com/read/27730488/smoking-related-attitudes-and-knowledge-among-medical-students-and-recent-graduates-in-argentina-a-cross-sectional-study
#14
M Victoria Salgado, Raúl M Mejía, Celia P Kaplan, Eliseo J Pérez-Stable
BACKGROUND: Physicians in Argentina smoke at rates similar to the general population, and do not have a clear role in tobacco control strategies. OBJECTIVE: To describe the attitudes and knowledge of medical students and recent graduates towards smoking behavior in Argentina. DESIGN: Cross-sectional self-administered online survey conducted in 2011. PARTICIPANTS: Medical students and recent medical graduates from the University of Buenos Aires...
October 11, 2016: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/27725024/comparison-of-the-prevalence-and-characteristics-of-inpatient-adverse-events-using-medical-records-review-and-incident-reporting
#15
W M Macharia, C M Muteshi, S Z Wanyonyi, A M Mukaindo, A Ismail, H Ekea, A Abdallah, J M Tole, A K Ngugi
BACKGROUND: Information on adverse events (AEs) in hospitalised patients in developing countries is scanty. OBJECTIVE: To compare the magnitude and characteristics of inpatient AEs in a tertiary, not-for-profit healthcare facility in Kenya, using medical records review and incident reporting. METHODS: Estimation of prevalence was done using incidents reported in 2010 from a random sample of medical records for hospital admissions. Nurse reviewers used 18 screening criteria, followed by physician reviewers to confirm occurrence...
September 8, 2016: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/27723012/poorly-designed-research-does-not-help-clarify-the-role-of-hyperbaric-oxygen-in-the-treatment-of-chronic-diabetic-foot-ulcers
#16
EDITORIAL
Mesut Mutluoglu, Gunalp Uzun, Michael Bennett, Peter Germonpré, David Smart, Daniel Mathieu
Diabetic foot ulcers (DFUs) are one of the most common indications for hyperbaric oxygen treatment (HBOT). The role of HBOT in DFUs is often debated. Recent evidence based guidelines, while recommending its use, urge further studies to identify the patient subgroups most likely to benefit from HBOT. A recent study in Diabetes Care aimed to assess the efficacy of HBOT in reducing the need for major amputation and improving wound healing in patients with chronic DFUs. In this study, patients with Wagner grade 2-4 diabetic foot lesions were randomly assigned to have HBOT (30 sessions/90 min/244 kPa) or sham treatment (30 sessions/90 min/air/125 kPa)...
September 2016: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/27692631/-map-of-resources-and-healthcare-needs-for-patients-with-dyslipidaemia-in-spain-the-madi-study
#17
Juan Pedro-Botet, Elisenda Climent, Eva Giralt Martínez, Juana A Flores-Le Roux
INTRODUCTION: Dyslipidaemia is a major modifiable determining factor of vascular risk and, despite this, a significant number of patients do not achieve lipid goals. The aim of this study is to describe the resources and current needs in clinical practice in Spain, through an analysis of management, organisation and the patient care circuit of dyslipidaemia patient. METHODS: A descriptive, cross-sectional, multicentre study, using a questionnaire, was conducted on physicians, 266 in primary care (PC) and 258 in specialised care (SC), who attended patients with dyslipidaemia in hospitals and centres within the National Health System...
September 27, 2016: Clínica e Investigación en Arteriosclerosis
https://www.readbyqxmd.com/read/27679955/prioritising-minimum-standards-of-emergency-care-for-children-in-resource-limited-settings
#18
Nicolaus W Glomb, Manish I Shah, Andrea T Cruz
BACKGROUND: There is global variation in the ability of hospital-based emergency centres to provide paediatric emergency medicine (PEM) services. Although minimum standards have been proposed, they may not be applicable in resource-limited settings. OBJECTIVE: The goal was to identify reasonable minimum standards to provide safe and effective care for acutely ill children in resource-limited settings. METHODS: Using previously proposed standards from the International Federation of Emergency Medicine (IFEM), a modified Delphi approach was used to reach agreement regarding minimum standards for PEM in resource-limited settings...
September 29, 2016: Paediatrics and International Child Health
https://www.readbyqxmd.com/read/27668921/script-concordance-testing-to-determine-infant-lumbar-puncture-practice-variation
#19
Nnenna Ogochukwu Chime, Martin V Pusic, Marc Auerbach, Renuka Mehta, Daniel J Scherzer, Wendy Van Ittersum, Brett McAninch, Daniel M Fein, Elizabeth Seelbach, Pavan Zaveri, Jennifer M Jackson, David Kessler, Todd P Chang
OBJECTIVES: Script concordance testing (SCT) is used to assess clinical decision-making. We explore the use of SCT to (1) quantify practice variations in infant lumbar puncture (LP) and (2) analyze physician's characteristics affecting LP decision making. METHODS: Using standard SCT processes, a panel of pediatric subspecialty physicians constructed 15 infant LP case vignettes, each with 2 to 4 SCT questions (a total of 47). The vignettes were distributed to pediatric attending physicians and fellows at 10 hospitals within the INSPIRE Network...
September 23, 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27647099/best-practices-for-safe-use-of-insulin-pen-devices-in-hospitals-recommendations-from-an-expert-panel-delphi-consensus-process
#20
Stuart T Haines, Margaret A Miklich, Charmaine Rochester-Eyeguokan
PURPOSE: A Delphi consensus development process was used to identify best practices for the safe use of insulin pen devices in hospitals. METHODS: A panel of healthcare professionals with experience in patient safety activities and development of insulin-use guidelines was selected. In round 1 of a 4-round Delphi process, panelists were asked to identify key concepts and practices relating to safe use of insulin pen devices in hospitals. In round 2, panelists indicated their level of agreement with draft practice statements reflecting input received in round 1; statements with strong support were refined based on panelist suggestions...
October 1, 2016: American Journal of Health-system Pharmacy: AJHP
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