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https://www.readbyqxmd.com/read/29324253/a-qualitative-study-comparing-physician-reported-barriers-to-treating-addiction-using-buprenorphine-and-extended-release-naltrexone-in-u-s-office-based-practices
#1
Barbara Andraka-Christou, Matthew J Capone
AIM: Our aim was to compare physician-reported barriers to sublingual buprenorphine (BUP) and extended-release naltrexone (XR-NLT) prescribing in U.S. office-based practices, and to identify potential policies for minimizing these barriers. Only one previous qualitative study has examined physician-reported barriers to prescribing XR-NLT and no qualitative study has compared physician-reported barriers between the two medications. METHODS: Researchers conducted individual semi-structured and in-depth interviews with 20 licensed physicians in four U...
January 8, 2018: International Journal on Drug Policy
https://www.readbyqxmd.com/read/29322848/inpatient-satisfaction-at-different-public-sector-hospitals-of-a-metropolitan-city-in-pakistan-a-comparative-cross-sectional-study
#2
Mehwish Hussain, Rehana Rehman, Zia Ikramuddin, Nava Asad, Ayesha Farooq
OBJECTIVE: To observe inpatient satisfaction at different public sector hospitals of Karachi, Pakistan. METHODS: A cross sectional study was carried out during 2010-2012 in four major public sector hospitals of Karachi. A total of 710 patients completed the study. Responses were gathered in a self-structured questionnaire that comprised of four dimensions of satisfaction with doctor, staff, administration and treatment. Average Score of each dimension was taken and compared using one way analysis of variance...
January 11, 2018: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/29313057/regional-differences-in-thrombectomy-rates-secondary-use-of-billing-codes-in-the-miracum-medical-informatics-for-research-and-care-in-university-medicine-consortium
#3
Christian Haverkamp, Thomas Ganslandt, Petar Horki, Martin Boeker, Arnd Dörfler, Stefan Schwab, Joachim Berkefeld, Waltraud Pfeilschifter, Wolf-Dirk Niesen, Karl Egger, Manfred Kaps, Marc A Brockmann, Eva Neumaier-Probst, Kristina Szabo, Martin Skalej, Siegfried Bien, Christoph Best, Hans-Ulrich Prokosch, Horst Urbach
BACKGROUND AND PURPOSE: Mechanical thrombectomy, in addition to intravenous (i.v.) thrombolysis is recommended for treatment of acute stroke in patients with large vessel occlusions (LVO) in the anterior circulation up to 6 h after symptom onset. We compared thrombectomy rates of eight university hospitals of the MIRACUM consortium to analyze the implementation of this guideline in clinical routine. METHODS: Anonymized billing data in a standardized format were loaded into a local i2b2 data warehouse by applying already existing extract, transform and load (ETL) routines...
January 8, 2018: Clinical Neuroradiology
https://www.readbyqxmd.com/read/29311532/the-formation-of-the-military-medical-system-of-the-korean-people-s-army-and-the-military-medical-officer
#4
Seonho Kim
The military medical system of the Korean People's Army (KPA) first appeared in August 1946 when a central military hospita was established at the headquarters. Inside the KPA, the military medical and veteran services were first established in February 1948. The military medical officers of the KPA were those who were initially engaged in North Korea's health care sector. Most of the early military medical officers were those who had been trained in the Japanese medical system before liberation and were surgeons...
December 2017: Ŭi Sahak
https://www.readbyqxmd.com/read/29300254/postoperative-catheter-management-after-pelvic-reconstructive-surgery-a-survey-of-practice-strategies
#5
Sarah S Boyd, Elena Tunitsky-Bitton, David M OʼSullivan, Adam C Steinberg
OBJECTIVE: The aim of this study was to evaluate practice preferences in catheter management after a failed inpatient voiding trial after pelvic reconstructive surgery. METHODS: This is a cross-sectional study of postoperative catheter management after pelvic reconstructive surgery after failed voiding trial. Physicians practicing at ACGME-accredited residencies and fellowships in Obstetrics and Gynecology (Ob/Gyn), Urology, and Female Pelvic Medicine and Reconstructive Surgery (FPMRS) within the United States completed a Web-based questionnaire in March 2017...
January 3, 2018: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/29298366/getting-it-rite-impact-of-a-dedicated-hospital-medicine-curriculum-for-residents
#6
Doris Lin, Chirayu Shah, Steffanie Campbell, Jeffrey T Bates, Erica Lescinskas
OBJECTIVE: The goal of this study was to improve resident confidence in inpatient care and knowledge in hospital medicine topics with a newly developed rotation and curriculum called the Resident Inpatient Training Experience. METHODS: This study was a prospective observational study completed by postgraduate year-2 (PGY-2) internal medicine residents in two affiliated hospitals. Forty-six PGY-2 residents each rotated on the Resident Inpatient Training Experience service for 1 month and completed a pre- and postrotation confidential online survey...
January 2018: Southern Medical Journal
https://www.readbyqxmd.com/read/29296131/geriatric-delirium-care-using-chart-audits-to-target-improvement-strategies
#7
Carla A Loftus, Lesley A Wiesenfeld
Background: Our hospital identified delirium care as a quality improvement target. Baseline characterization of our delirium care and deficits was needed to guide improvement efforts. Methods: Two inpatient units were selected: 1) A general internal medicine unit with a focus on geriatrics, and 2) a surgical unit. Retrospective chart audits were conducted for all patients over age 50 admitted during a one-month period to compare delirium care with best practice guideline (BPG) recommendations, and to determine the incidence of missed cases of delirium and negative outcomes in patients with delirium...
December 2017: Canadian Geriatrics Journal: CGJ
https://www.readbyqxmd.com/read/29295637/clostridial-collagenase-ointment-and-medicinal-honey-utilization-for-pressure-ulcers-in-u-s-hospitals
#8
Jill Dreyfus, Gary Delhougne, Bobbie James, Julie Gayle, Curtis Waycaster
AIMS: Describe the utilization of clostridial collagenase ointment (CCO) and medicinal honey debridement methods in real-world inpatient and outpatient hospital settings among pressure ulcer (PU) patients and compare the frequency of healthcare re-encounters between CCO- and medicinal honey-treated patients. MATERIALS AND METHODS: De-identified hospital discharge records for patients receiving CCO or medicinal honey methods of debridement and having an ICD-9 code for PU were extracted from the U...
January 3, 2018: Journal of Medical Economics
https://www.readbyqxmd.com/read/29290047/predictive-modeling-of-inpatient-mortality-in-departments-of-internal-medicine
#9
Naama Schwartz, Ali Sakhnini, Naiel Bisharat
Despite overwhelming data on predictors of inpatient mortality, it is unclear which variables are the most instructive in predicting mortality of patients in departments of internal medicine. This study aims to identify the most informative predictors of inpatient mortality, and builds a prediction model on an individual level, given a constellation of patient characteristics. We use a penalized method for developing the prediction model by applying the least-absolute-shrinkage and selection-operator regression...
December 30, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/29288619/analysis-of-cyp2c19-genetic-polymorphism-in-a-large-ethnic-hakka-population-in-southern-china
#10
Zhixiong Zhong, Jingyuan Hou, Bing Li, Qifeng Zhang, Sudong Liu, Cunren Li, Zhidong Liu, Min Yang, Wei Zhong, Pingsen Zhao
BACKGROUND Cytochrome P450 (CYP) 2C19 is an enzyme involved in the bioactivation of various important therapeutic drugs, from pro-drugs to an active inhibitor of platelet action. Variants in the CYP2C19 gene influence the pharmacokinetics and clinical response to antiplatelet drugs such as clopidogrel; however, there is no available data about the genetic variation of CYP2C19 in the Hakka population in China. MATERIAL AND METHODS A total of 6686 unrelated participants (ages 17-98 years) of self-reported Hakka ancestry admitted at an inpatient department in a hospital in southern China were successfully genotyped by the gene chip platform...
December 30, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/29279953/chemical-peeling-with-a-modified-phenol-formula-for-the-treatment-of-facial-freckles-on-asian-skin
#11
Hua-Feng Sun, Hai-Shan Lu, Le-Qi Sun, Wei-Dong Ping, Dong-Sheng Mao, Dan Li
BACKGROUND: Chemical peeling is an efficient method for the treatment of pigment disorders. For freckles, medium-depth to deep peeling using a phenol solution is one of the most effective chemical peels, and modifications of facial skin can be observed up to 20 years after peeling. However, applying phenol to the skin may cause serious side effects. Phenol peeling has been rarely used in Asia due to its tendency to cause permanent pigmentary changes and hypertrophic scars. METHODS: In total, 896 Chinese inpatients with facial freckles were enrolled in this study...
December 26, 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/29279886/association-of-hospitalist-years-of-experience-with-mortality-in-the-hospitalized-medicare-population
#12
James S Goodwin, Habeeb Salameh, Jie Zhou, Siddhartha Singh, Yong-Fang Kuo, Ann B Nattinger
Importance: Substantial numbers of hospitalists are fresh graduates of residency training programs. Current data about the effect of hospitalist years of experience on patient outcomes are lacking. Objective: To describe the association of hospitalist years of experience with 30-day mortality and hospital mortality of their patients. Design, Setting, and Participants: We used a 5% sample of national Medicare data of patient and hospital characteristics to build a multilevel logistic regression model to predict mortality as a function of years of experience of the hospitalists...
December 26, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/29277907/a-multicentre-study-investigating-vital-sign-changes-occurring-in-complicated-and-uncomplicated-transfusions
#13
E A Gehrie, N H Roubinian, D Chowdhury, D J Brambilla, E L Murphy, J L Gottschall, Y Wu, P M Ness, R G Strauss, J E Hendrickson
BACKGROUND AND OBJECTIVES: Many hospitals require transfusions to be discontinued when vital signs stray from predetermined ranges, regardless of clinical symptoms. Variations in vital signs may be unrelated to transfusion, however, and needlessly stopping a transfusion may delay medical care while increasing donor exposures and healthcare costs. We hypothesized that a detailed study of vital sign changes associated with transfusion of blood product by component, including those associated with potential reactions (complicated) and those deemed to be uncomplicated, would establish a useful framework of reference for treating clinicians and transfusion services alike...
December 25, 2017: Vox Sanguinis
https://www.readbyqxmd.com/read/29277629/patterns-and-correlates-of-cervical-cancer-screening-initiation-in-a-large-integrated-healthcare-system
#14
Tracy A Becerra-Culqui, Neal M Lonky, Qiaoling Chen, Chun R Chao
BACKGROUND: The latest 2012 United States Preventive Services Task Force cervical cancer screening guidelines recommended screening initiation at age 21 years. Little is known about the cervical cancer screening initiation practices in the community, and whether there are critical gaps with respect to adherence to current clinical guidelines. Despite an overall decline in cervical cancer incidence across women of all ages, the incidence rate has not declined among 24-25 year-olds between 2000 (2...
December 22, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29276764/relationship-between-patient-satisfaction-and-physician-characteristics
#15
J Gene Chen, Baiming Zou, Jonathan Shuster
Background: Physician care influences patient satisfaction. Inherent physician attributes may also affect scores. Objective: To determine the relationship between physician characteristics and patient satisfaction regarding physician care and communication. Method: Observational retrospective study. We examined patient satisfaction surveys from inpatient adults across 9 questions (HCAHPS: Courtesy, Listen, and Explain; Press Ganey: Time, Concern, Informed, Friendliness, Skill, Rating) in relation to physician gender, age, ethnicity, race, and specialty...
December 2017: Journal of Patient Experience
https://www.readbyqxmd.com/read/29273289/inpatient-consults-and-complications-during-primary-total-joint-arthroplasty-in-a-bundled-care-model
#16
Billy T Baumgartner, Vasili Karas, Beau J Kildow, Daniel J Cunningham, Mitchell R Klement, Cindy L Green, David E Attarian, Thorsten M Seyler
BACKGROUND: The Centers for Medicare and Medicaid Services (CMS) are implementing changes in hospital reimbursement models for total joint arthroplasty (TJA), moving to value-based bundled payments from the fee-for-service model. The purpose of this study is to identify consults and complications during the perioperative period that increase financial burden. METHODS: We combined CMS payment data for inpatient, professional, and postoperative with retrospective review of patients undergoing primary TJA and developed profiles of patients included in the Comprehensive Care for Joint Replacement bundle undergoing TJA...
November 29, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29251063/decreased-rates-of-inpatient-hypoglycemia-following-implementation-of-an-automated-tool-in-the-electronic-medical-record-for-identifying-root-causes
#17
Naina Sinha Gregory, Jane Jeffrie Seley, Jenny Ukena, Sona Shah, Matthew R Fred, Savira Kochhar Dargar, Elizabeth Mauer, Robert J Kim
OBJECTIVE: The objective was to identify root causes of hypoglycemia on medicine inpatient units using an automated tool. Data collected will guide educational interventions aimed at improving patient care and safety by decreasing rates of hypoglycemia. METHODS: A survey was conducted among RNs to identify risk factors for hypoglycemia. Survey data were used to create a hypoglycemia root cause survey tool in the EMR. RNs were prompted to utilize the tool when blood glucose (BG) < 70 mg/dL...
December 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/29250670/an-overview-of-resistance-profiles-eskape-pathogens-from-2010-2015-in-a-tertiary-respiratory-center-in-romania
#18
Nicolae Ovidiu Peneş, Andrei Alexandru Muntean, Adriana Moisoiu, Mădălina Maria Muntean, Alexandru Chirca, Miron Alexandru Bogdan, Mircea Ioan Popa
Lower respiratory tract infections (LRTIs) is an umbrella term that covers a wide spectrum of diseases, comprising mild and severe, acute and chronic conditions. A wide spectrum of pathogens can be implicated, from viruses to pyogenic and atypical bacteria. A special place should be reserved for slow growing bacteria (Mycobacteria spp., Nocardia spp.) and parasites (i.e., hydatic cysts caused by Echinococcus granulosus). OBJECTIVE: The objective of this study is to observe, analyze and establish the drug susceptibility patterns for Enterococcus spp...
2017: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
https://www.readbyqxmd.com/read/29237706/patient-characteristics-resource-use-and-outcomes-associated-with-general-internal-medicine-hospital-care-the-general-medicine-inpatient-initiative-gemini-retrospective-cohort-study
#19
Amol A Verma, Yishan Guo, Janice L Kwan, Lauren Lapointe-Shaw, Shail Rawal, Terence Tang, Adina Weinerman, Peter Cram, Irfan A Dhalla, Stephen W Hwang, Andreas Laupacis, Muhammad M Mamdani, Steven Shadowitz, Ross Upshur, Robert J Reid, Fahad Razak
BACKGROUND: The precise scope of hospital care delivered under general internal medicine services remains poorly quantified. The purpose of this study was to describe the demographic characteristics, medical conditions, health outcomes and resource use of patients admitted to general internal medicine at 7 hospital sites in the Greater Toronto Area. METHODS: This was a retrospective cohort study involving all patients who were admitted to or discharged from general internal medicine at the study sites between Apr...
December 11, 2017: CMAJ Open
https://www.readbyqxmd.com/read/29237654/investigating-the-effect-of-sociodemographic-factors-on-30-day-hospital-readmission-among-medical-patients-in-toronto-canada-a-prospective-cohort-study
#20
Robert W Smith, Kerry Kuluski, Andrew P Costa, Samir K Sinha, Richard H Glazier, Alan Forster, Lianne Jeffs
OBJECTIVE: To examine the influence of patient-level sociodemographic factors on the incidence of hospital readmission within 30 days among medical patients in a large Canadian metropolitan city. DESIGN: Prospective cohort study. SETTING AND PARTICIPANTS: Patients admitted to the General Internal Medicine service of an urban teaching hospital in Toronto, Canada participated in a survey of sociodemographic information. Patients were not surveyed if deemed medically unstable, receiving care in medical/surgical step-down beds or were isolated for infection control...
December 12, 2017: BMJ Open
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