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medical rounds

Kirsten Beck, Elaine Albert, Andrew Johnsen, Courtney Newhouse, John McGuire
Medical rounds in the Pediatric Intensive Care Unit (PICU) took about four hours each day to complete. The length of rounds was affecting the advancement of care of the patients, the engagement of sub-specialty providers who needed to be present on other rounds, and the engagement of the PICU faculty and staff due to overburdening waste created by the long duration of rounds. Specific interventions were identified aimed at reducing the duration of rounds each day, increasing engagement of the rounding team and satisfying the needs of the patients and families...
2016: BMJ Quality Improvement Reports
Frederick A Jakobiec, Anna M Stagner, Natalie Homer, Michael K Yoon
PURPOSE: To further define the histopathologic features of breast carcinoma conducive to orbital metastasis. METHODS: Ten new female patients with orbital or eyelid breast cancer metastases encountered between 2011 and 2016 had their medical records reviewed for determining their clinical characteristics. Microscopic glass slides from biopsies and immunohistochemical test results were also analyzed. Biomarkers studied included cytokeratin 7, nuclear estrogen and progesterone receptors, HER2, and E-cadherin...
October 5, 2016: Ophthalmic Plastic and Reconstructive Surgery
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
Paulo Henrique de Souza Castro, Luiz Evaristo Ricci Volpato, Julia Tramujas, Alvaro Henrique Borges
Lingual thyroid is defined as an ectopic thyroid gland tissue located in the midline of the tongue base and it is uncommonly observed in clinical practice and is rare in children. This paper describes the surgical treatment of ectopic thyroid at the base of the tongue in a child. The chief complaint of the 12-year-old, melanodermic female patient was the difficulty to swallow for 15 days. The intraoral physical examination barely showed a nodular lesion at tongue base. The CT scan showed a round, well defined hyperdense lesion of approximately 25...
2016: Case Reports in Dentistry
Daniel S Lemke, Elaine K Fielder, Deborah C Hsu, Cara B Doughty
INTRODUCTION: Simulation-based medical education (SBME) improves medical knowledge compared with no intervention. In traditional SBME, more time is spent debriefing than practicing skills. Rapid cycle deliberate practice (RCDP) simulation allows learners to practice skills repetitively, receive brief interspersed feedback, and has been shown to improve individual performance of resuscitation skills in simulation; it has not been compared with traditional simulation methods. OBJECTIVE: The aim of the study was to compare traditional and RCDP SBME...
October 6, 2016: Pediatric Emergency Care
Hansong Li, Chuanping Gao, Guoqian Wang, Ningsong Qu, Di Zhu
The titanium alloy Ti-6Al-4V is used in many industries including aviation, automobile manufacturing, and medical equipment, because of its low density, extraordinary corrosion resistance and high specific strength. Electrochemical machining (ECM) is a non-traditional machining method that allows applications to all kinds of metallic materials in regardless of their mechanical properties. It is widely applied to the machining of Ti-6Al-4V components, which usually takes place in a multicomponent electrolyte solution...
October 13, 2016: Scientific Reports
Jason P Stopyra, William P Bozeman, David W Callaway, James Winslow, Henderson D McGinnis, Justin Sempsrott, Lisa Evans-Taylor, Roy L Alson
There is some controversy about whether ballistic protective equipment (body armor) is required for medical responders who may be called to respond to active shooter mass casualty incidents. In this article, we describe the ongoing evolution of recommendations to optimize medical care to injured victims at such an incident. We propose that body armor is not mandatory for medical responders participating in a rapid-response capacity, in keeping with the Hartford Consensus and Arlington Rescue Task Force models...
2016: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
Martina Scharitzer, Peter Pokieser, Michaela Wagner-Menghin, Ferdinand Otto, Olle Ekberg
PURPOSE: Clinical assessment of swallowing disorders (dysphagia) requires accurate and comprehensive medical history-taking to further tailor the diagnostic work-up, but functional health care questionnaires show a large variability and various limitations. The aim of this study was to assess the way in which international swallowing experts from various disciplines asses swallowing problems in order to improve the radiologist´s ability to take a thorough medical history in this specific patient group...
October 11, 2016: Abdominal Radiology
Vincent C Tam, Paris-Ann Ingledew, Scott Berry, Sunil Verma, Meredith E Giuliani
BACKGROUND: Studies have shown that there is a deficiency in focused oncology teaching during medical school in Canada. This study aimed to develop oncology education goals and objectives for medical students through consensus of oncology educators from across Canada. METHODS: In 2014 we created a comprehensive list of oncology education objectives using existing resources. Experts in oncology education and undergraduate medical education from all 17 Canadian medical schools were invited to participate in a 3-round modified Delphi process...
July 2016: CMAJ Open
Peri Kocabayoglu, Martin Husen, Oliver Witzke, Andreas Kribben, Fuat H Saner, Ali Canbay, Guido Gerken, Andreas Paul
BACKGROUND: Morbidity and mortality conferences (MMCs) provide powerful opportunities for learning, reflection, and improvement. The current literature gives examples of how MMCs can be designed; however, no systematic review of cases and no original data related to liver transplantation are available. Liver transplantation requires a multidisciplinary approach to case identification, presentation, and analysis. Framework structures that guide case investigation are needed to successfully follow up on outcome measures and provide the basis for quality assessment and transparency in transplant programs...
August 2016: Visc Med
James D Mitchell, Thomas J Chesnut, David V Eastham, Carlo N Demandante, David J Hoopes
PURPOSE: In 2012, we instituted detailed prospective peer review of new cases. We present the outcomes of peer review on patient management and time required for peer review. METHODS AND MATERIALS: Peer review rounds were held 3 to 4 days weekly and required 2 physicians to review pertinent information from the electronic medical record and treatment planning system. Eight aspects were reviewed for each case: 1) workup and staging; 2) treatment intent and prescription; 3) position, immobilization, and simulation; 4) motion assessment and management; 5) target contours; 6) normal tissue contours; 7) target dosimetry; and 8) normal tissue dosimetry...
August 31, 2016: Practical Radiation Oncology
Dominika Batycka-Stachnik, Agnieszka Piwoda, Tomasz Darocha, Malgorzata Spiewak, Sylweriusz Kosinski, Anna Jarosz, Hubert Hymczak, Tomasz Sanak, Robert Galazkowski, Jacek Piatek, Janusz Konstanty-Kalandyk, Rafal Drwila
: The objectives: To show and discuss the most frequent functional problems encountered in patients who underwent extracorporeal membrane oxygenation (ECMO) treatment after severe hypothermia and point out appropriate physiotherapy procedures used in order to diminish the effects of hypothermia on the human organism. It is necessary to look for effective physiotherapeutic solutions, especially that the number of scientific publications on the subject is very limited. DESIGN: Retrospective analysis Setting: Severe Accidental Hypothermia Center ( medical intensive care unit of a university hospital) Patients or participants: Nineteen patients who were qualified for ECMO in Severe Accidental Hypothermia Center Intervention: At least three times a day rehabilitation session (physiotherapeutic procedures adequate to patient problems) and interventions in case of emergency...
2016: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
Y-W Sha, L Ding, J-X Wu, S-B Lin, X Wang, Z-Y Ji, P Li
Spermatozoa morphology, an important parameter in a semen specimen's potential fertility evaluation, is a significant factor for in vitro fertilisation in assisted reproductive technology. Eleven sterile men with headless spermatozoa, a type of human teratozoospermia, are presented. Their ejaculates' headless spermatozoa percentages were high with rare normal spermatozoa forms. Additionally, abnormal morphology (e.g. round-headed or microcephalic spermatozoa) was also found. Spermatozoa motility was somewhat affected, potentially because of the missing mitochondrial sheath at the sperm tail base...
October 6, 2016: Andrologia
Christos Dervenis, Evaghelos Xynos, George Sotiropoulos, Nikolaos Gouvas, Ioannis Boukovinas, Christos Agalianos, Nikolaos Androulakis, Athanasios Athanasiadis, Christos Christodoulou, Evangelia Chrysou, Christos Emmanouilidis, Panagiotis Georgiou, Niki Karachaliou, Ourania Katopodi, Panteleimon Kountourakis, Ioannis Kyriazanos, Thomas Makatsoris, Pavlos Papakostas, Demetris Papamichael, George Pechlivanides, Georgios Pentheroudakis, Ioannis Pilpilidis, Joseph Sgouros, Paris Tekkis, Charina Triantopoulou, Maria Tzardi, Vassilis Vassiliou, Louiza Vini, Spyridon Xynogalos, Nikolaos Ziras, John Souglakos
There is discrepancy and failure to adhere to current international guidelines for the management of metastatic colorectal cancer (CRC) in hospitals in Greece and Cyprus. The aim of the present document is to provide a consensus on the multidisciplinary management of metastastic CRC, considering both special characteristics of our Healthcare System and international guidelines. Following discussion and online communication among the members of an executive team chosen by the Hellenic Society of Medical Oncology (HeSMO), a consensus for metastastic CRC disease was developed...
October 2016: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
Aimee Alphonso, Marc Auerbach, Kirsten Bechtel, Kyle Bilodeau, Marcie Gawel, Jeannette Koziel, Travis Whitfill, Gunjan Kamdar Tiyyagura
OBJECTIVES: To develop and provide validity evidence for a performance checklist to evaluate the child abuse screening behaviors of prehospital providers. METHODS: Checklist Development: We developed the first iteration of the checklist after review of the relevant literature and on the basis of the authors' clinical experience. Next, a panel of six content experts participated in three rounds of Delphi review to reach consensus on the final checklist items. Checklist Validation: Twenty-eight emergency medical services (EMS) providers (16 EMT-Basics, 12 EMT-Paramedics) participated in a standardized simulated case of physical child abuse to an infant followed by one-on-one semi-structured qualitative interviews...
October 4, 2016: Prehospital Emergency Care
Gerald W Smetana, Martin J Abrahamson, David M Rind
The prevalence of diabetes in the United States is rising. Twelve percent of U.S. adults have diabetes and another 37% have impaired fasting glucose or impaired glucose tolerance. Diabetes is a major risk factor for such outcomes as cardiovascular disease, blindness, chronic kidney disease, and limb amputation. An important consideration is whether screening for abnormal glucose levels or diabetes reduces cardiovascular or all-cause morbidity and mortality. In October 2015, the U.S. Preventive Services Task Force published recommendations on screening for abnormal blood glucose and concluded that intensive lifestyle interventions have a moderate benefit in reducing progression to diabetes in patients who have abnormal blood glucose levels detected by screening...
October 4, 2016: Annals of Internal Medicine
Katharine Reid, David Smallwood, Margo Collins, Ruth Sutherland, Agnes Dodds
BACKGROUND: To ensure the rigour of objective structured clinical examinations (OSCEs) in assessing medical students, medical school educators must educate examiners with a view to standardising examiner assessment behaviour. Delivering OSCE examiner training is a necessary yet challenging part of the OSCE process. A novel approach to implementing training for current and potential OSCE examiners was trialled by delivering large-group education sessions at major teaching hospitals. METHODS: The 'OSCE Roadshow' comprised a short training session delivered in the context of teaching hospital 'Grand Rounds' to current and potential OSCE examiners...
2016: Medical Education Online
Fatemeh Keshmiri, Sari Ponzer, AmirAli Sohrabpour, Shervin Farahmand, Farhad Shahi, Shahram Bagheri-Hariri, Kamran Soltani-Arabshahi, Mandana Shirazi, Italo Masiello
BACKGROUND: Simulation can be used for educating, evaluating and assessing psychometric properties of an instrument. The aim of this study was to contextualize and assess the validity and reliability of the Interprofessional Collaborative Assessment tool (ICAR) in an Iranian context using simulation. METHODS: In this descriptive study, contextualization of the ICAR was assessed through several steps. Firstly, validity assessment was approved through expert panels and Delphi rounds...
2016: Medical Journal of the Islamic Republic of Iran
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
Lioudmila V Karnatovskaia, Margaret M Johnson, Travis J Dockter, Ognjen Gajic
PURPOSE: Survivors of critical illness are frequently unable to return to their premorbid level of psychocognitive functioning following discharge. Therefore, we aimed to evaluate the burden of psychological trauma experienced by patients in the intensive care unit (ICU) as perceived by clinicians to assess factors that can impede its recognition and treatment in the ICU. MATERIALS AND METHODS: Two distinct role-specific Web-based surveys were administered to critical care physicians and nurses in medical and surgical ICUs of 2 academic medical centers...
September 14, 2016: Journal of Critical Care
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