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Residents' clinic

Todd P Chang, Sheree M Schrager, Alyssa J Rake, Michael W Chan, Phung K Pham, Grant Christman
Multimedia in assessing clinical decision-making skills (CDMS) has been poorly studied, particularly in comparison to traditional text-based assessments. The literature suggests multimedia is more difficult for trainees. We hypothesize that pediatric residents score lower in diagnostic skill when clinical vignettes use multimedia rather than text for patient findings. A standardized method was developed to write text-based questions from 60 high-resolution, quality multimedia; a series of expert panels selected 40 questions with both a multimedia and text-based counterpart, and two online tests were developed...
October 17, 2016: Advances in Health Sciences Education: Theory and Practice
Jae Hyun Kwon, Chang Hwan Sohn, Jae Ho Lee, Bum Jin Oh
OBJECTIVE: The supply of emergency medicine (EM) specialists has not been able to meet demand in the past decade. This study comparatively analyzed clinical findings to provide fundamental data to inform efficient utilization of a limited number of EM specialists. METHODS: This retrospective study included 54,204 patients who visited the emergency department of a tertiary care medical center from March 1 to December 31, 2012. The experimental specialist-supervised (SS) group included patients supervised by an EM specialist, while the control specialist-on-call (SOC) group included patients attended by a senior resident of EM with an EM specialist on call...
March 2016: Clin Exp Emerg Med
Daniel V Mogford, Rebecca J Lawrence
Aims and method To investigate the burden of medical comorbidity in a population receiving in-patient treatment for drug and alcohol problems. All patients admitted over a 6-month period were included in the data-set. We recorded diagnostic information on admission that allowed the calculation of predicted 10-year survival using a previously validated comorbidity index. Results Despite the majority of the sample having a predicted 10-year survival chance of greater than 75%, a sizeable minority (16.7%) are carrying a high burden of medical comorbidity, with a predicted 10-year survival chance of less than 50%...
October 2016: BJPsych Bulletin
Andreas Schlitzer, Joachim L Schultze
Tissue macrophages of fetal and adult origin have pivotal roles in tissue homeostasis and organ inflammation. Recently several functional and transcriptomic studies have revealed their unique module-like transcriptomic organization leading to enormous tissue-dependent functional plasticity. In this review, we discuss the development, tissue adaption and function of resident murine and human macrophages. Finally, we discuss our limited knowledge on human tissue macrophages and provide our opinion on their relevance during disease and for clinical application...
October 18, 2016: Immunology and Cell Biology
S Vigoureux, A Perreaud, G Legendre, D Salet-Lizée, R Villet
OBJECTIVES: For the treatment of prolapse, the vaginal route is less standardized than laparoscopy and seems abandoned by younger doctors. Our objectives were to evaluate the surgical experience of resident and youth gynecology and obstetrics assistants in pelviperineology and the level of confidence and mastery of the different surgical treatment of pelvic. METHODS: An anonymous questionnaire sent via an Internet platform interviewing residents and young assistants of gynecology and obstetrics (promotion 2005 to 2010) in France on their surgical training in pelviperineology...
October 14, 2016: Gynécologie, Obstétrique & Fertilité
Ruixue Miao, Zhiling Wang, Qin Guo, Yang Wen, Qiong Liao, Yu Zhu, Min Shu, Chaomin Wan
BACKGROUND: Visceral Leishmaniasis (VL) is a life-threatening parasitic infection transmitted by phlebotomine sandflies. We undertook this study to analyze the clinical features of pediatric VL in a population of Chinese children. METHODS: A retrospective study was performed with pediatric patients (≤14years) diagnosed with VL based on bone-marrow biopsy, serology and diagnosis based on clinical manifestation and the improvement after the experimental drug when negative bone marrow and serology results were shown...
September 30, 2016: Pediatric Infectious Disease Journal
Tomohiro Sonoo, Satoshi Iwai, Ryota Inokuchi, Masataka Gunshin, Yoichi Kitsuta, Susumu Nakajima
Along with article-based checklists, structured template recording systems have been reported as useful to create more accurate clinical recording, but their contributions to the improvement of the quality of patient care have been controversial. An emergency department (ED) must manage many patients in a short time. Therefore, such a template might be especially useful, but few ED-based studies have examined such systems.A structured template produced according to widely used head injury guidelines was used by ED residents for head injury patients...
October 2016: Medicine (Baltimore)
Zulfi Haneef, Sharon Chiang, Holly Rutherford, Arun Antony
INTRODUCTION: Fellowship training in Clinical Neurophysiology (CNP) is often sought following Neurology residency. However, data documenting the reasons for choosing CNP fellowship, and experiences therein, are sparse. METHODS: Current Neurophysiology fellows across the United States participated in a 17-item, internet-based survey. Data regarding demographics, reasons for choosing fellowship, adequacy of training, and future plans were collected. RESULTS: Among respondents (n=49), 84% graduated from a US medical school...
October 5, 2016: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
Christopher Varga, Isaac Luria, Nikolaus Gravenstein
BACKGROUND: Air injection is carefully avoided during IV solution administration; however, ambient air is dissolved in all liquids used for intravenous (IV) therapy. A portion of this gas will come out of solution in the form of bubbles as the solution is warmed to body temperature in a fluid warming system and/or within the body. We sought to quantify the proportion of the gas theoretically dissolved in room temperature crystalloid and 4°C blood products that comes out of solution in the IV tubing on warming to 37°C...
October 3, 2016: Anesthesia and Analgesia
Filipa Alves da Costa, Luísa Silvestre, Catarina Periquito, Clara Carneiro, Pedro Oliveira, Ana Isabel Fernandes, Patrícia Cavaco-Silva
BACKGROUND: Currently, people live longer but often with poor quality of life. The decrease in healthy life-years is partly attributable to the institution of polypharmacy to treat various comorbidities. OBJECTIVES: The objectives of the study were to determine the prevalence and nature of drug-related problems (DRPs) in polypharmacy elderly patients residing in nursing homes and to test the acceptability of a pharmacist's intervention. METHODS: An exposure cohort was constituted in three Portuguese nursing homes, where all polypharmacy (five or more medicines) elderly patients (≥65 years of age) were analysed and then a random stratified sample was extracted to be subject to an intervention...
March 2016: Drugs—Real World Outcomes
Kayle Shapero, James Deluca, Miranda Contursi, Meagan Wasfy, Rory B Weiner, Gregory D Lewis, Adolph Hutter, Aaron L Baggish
BACKGROUND: Masters athletes (MAs), people over the age of 35 that participate in competitive sports, are a rapidly growing population that may be uniquely at risk for cardiovascular (CV) disease. The objective of this study was to develop a comprehensive clinical CV profile of MA. METHODS: An electronic Internet-based survey (survey response rate = 66 %) was used to characterize a community cohort of MAs residing in Eastern Massachusetts, USA. Clinical and lifestyle factors associated with prevalent CV disease were determined using logistic regression...
December 2016: Sports Medicine—Open
Johann Malina-Altzinger, Georg Damerau, Klaus W Grätz, P D Bernd Stadlinger
BACKGROUND: The aim of this study was to evaluate the validity and the inter- and intra-examiner reliability of panoramic-radiograph-driven findings of different maxillary sinus anatomic variations and pathologies, which had initially been prediagnosed by cone beam computed tomography (CBCT). METHODS: After pairs of two-dimensional (2D) panoramic and three-dimensional (3D) CBCT images of patients having received treatment at the outpatient department had been screened, the predefinition of 54 selected maxillary sinus conditions was initially performed on CBCT images by two blinded consultants individually using a questionnaire that defined ten different clinically relevant findings...
December 2015: Int J Implant Dent
Kevin Kalisz, Vasant Garg, Kyle Basques, Robert Gilkeson, Peter Young
RATIONALE AND OBJECTIVES: This study aimed to assess the quality of and analyze trends among clinical indications received for emergency room radiograph studies. MATERIALS AND METHODS: Clinical indications provided by the emergency room and rapid care for consecutive chest, abdominal, and musculoskeletal radiographs were reviewed. Chart review was performed to analyze the provided indications compared to clinical information known to the ordering providers. Chest and abdominal radiograph indications were graded according to symptoms and physical examination signs and relevant past medical history...
October 10, 2016: Academic Radiology
Nicholas S Sigona, Jeffrey M Steele, Christopher D Miller
OBJECTIVES: To determine the impact of a pharmacist-driven beta-lactam allergy interview on antimicrobial therapy. SETTING: Tertiary care academic medical center. PRACTICE SETTING: Clarification of beta-lactam allergy may expand treatment options for patients and potentially improve outcomes, reduce toxicity, and reduce costs. PRACTICE INNOVATION: At our institution, a pilot service using a pharmacy resident and infectious diseases clinical pharmacist was implemented to clarify beta-lactam allergy information and, where appropriate, recommend a change to the patient's antibiotic therapy...
October 8, 2016: Journal of the American Pharmacists Association: JAPhA
Mandira Paul, Sharad D Iyengar, Birgitta Essén, Kristina Gemzell-Danielsson, Kirti Iyengar, Johan Bring, Marie Klingberg-Allvin
BACKGROUND: Post-abortion contraceptive use in India is low and the use of modern methods of contraception is rare, especially in rural areas. This study primarily compares contraceptive use among women whose abortion outcome was assessed in-clinic with women who assessed their abortion outcome at home, in a low-resource, primary health care setting. Moreover, it investigates how background characteristics and abortion service provision influences contraceptive use post-abortion. METHODS: A randomized controlled, non-inferiority, trial (RCT) compared clinic follow-up with home-assessment of abortion outcome at 2 weeks post-abortion...
October 17, 2016: BMC Public Health
Eman M Khedr, Gharib Fawi, Mohammed Abd-Allah Abbas, Noha Abo El-Fetoh, Ahmed F Zaki, Ayman Gamea, Ghada Al Attar
BACKGROUND: Few epidemiological studies of the prevalence of neuromuscular disorders have been undertaken. The aim of the study was to estimate the prevalence of the most common types of neuromuscular disorders in Qena governorate/Egypt. METHODS: A random sample was taken from 11 districts, involving 9303 inhabitants with 57.3% urban residents and 42.7% rural residence. Patients were diagnosed using a screening questionnaire for the diagnosis of neuromuscular disorders...
October 17, 2016: Neurological Research
David U Olveda, Marianette Inobaya, Donald P McManus, Remigio M Olveda, Marilyn L Vinluan, Shu-Kay Ng, Donald A Harn, Yuesheng Li, Jerric R Guevarra, Alfred K Lam, Allen G P Ross
OBJECTIVE: This study assessed the impact of annual versus biennial praziquantel treatment regimens on Asiatic schistosomiasis (caused by Schistosoma japonicum) prevalence, intensity of infection, and liver fibrosis dynamics among individuals residing in 18 endemic barangays in Northern Samar, Philippines. METHODS: 565 subjects who reported symptoms of gastrointestinal illness and/or were believed to have clinical morbidity based on physical examination were selected for cohort follow-up...
October 12, 2016: International Journal of Infectious Diseases: IJID
Laurence Greene, Kathleen Moreo, Henry Nasrallah, Rajiv Tandon, Tamar Sapir
OBJECTIVE: In the context of an educational program on schizophrenia for psychiatry trainees, this survey study analyzed associations between self-reported training adequacy, experience in providing patient care, and comfort level in performing schizophrenia-related clinical skills. The influence of the education on comfort level was also assessed for each skill. METHODS: Survey respondents were psychiatry residents and fellows who participated in a schizophrenia education program at an in-person workshop or through online videos recorded at the workshop...
October 14, 2016: Academic Psychiatry
Marios K Georgakis, Maria A Karalexi, Eleni I Kalogirou, Anton Ryzhov, Anna Zborovskaya, Nadya Dimitrova, Sultan Eser, Luis Antunes, Mario Sekerija, Tina Zagar, Joana Bastos, Domenic Agius, Margareta Florea, Daniela Coza, Evdoxia Bouka, Charis Bourgioti, Helen Dana, Emmanuel Hatzipantelis, Maria Moschovi, Savvas Papadopoulos, Georgios Sfakianos, Evgenia Papakonstantinou, Sophia Polychronopoulou, Spyros Sgouros, Kalliopi Stefanaki, Eftichia Stiakaki, Katerina Strantzia, Basilios Zountsas, Apostolos Pourtsidis, Eustratios Patsouris, Eleni Th Petridou
Pilocytic astrocytomas (PA) comprise the most common childhood central nervous system (CNS) tumor. Exploiting registry-based data from Southern and Eastern Europe (SEE) and SEER, US, we opted to examine incidence, time trends, survival and tentative outcome disparities of childhood PA by sociodemographic and clinical features. Childhood PA were retrieved from 12 SEE registries (N = 552; 1983-2014) and SEER (N = 2723; 1973-2012). Age-standardized incidence rates (ASR) were estimated and survival was examined via Kaplan-Meier and Cox regression analysis...
October 14, 2016: Journal of Neuro-oncology
Chiara Cencioni, Sandra Atlante, Matteo Savoia, Fabio Martelli, Antonella Farsetti, Maurizio C Capogrossi, Andreas M Zeiher, Carlo Gaetano, Francesco Spallotta
Organ-specific mesenchymal cells naturally reside in the stroma, where they are exposed to some environmental variables affecting their biology and functions. Risk factors such as diabetes or aging influence their adaptive response. In these cases, permanent epigenetic modifications may be introduced in the cells with important consequences on their local homeostatic activity and therapeutic potential. Numerous results suggest that mesenchymal cells, virtually present in every organ, may contribute to tissue regeneration mostly by paracrine mechanisms...
October 11, 2016: Pharmacology & Therapeutics
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