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https://www.readbyqxmd.com/read/28742774/improving-adherence-to-intraoperative-lung-protective-ventilation-strategies-at-a-university-medical-center
#1
Sean A Josephs, Gretchen A Lemmink, Judith A Strong, Cassandra L Barry, William E Hurford
BACKGROUND: Intraoperative lung-protective ventilation (ILPV) is defined as tidal volumes <8 mL/kg ideal bodyweight and is increasingly a standard of care for major abdominal surgical procedures performed under general anesthesia. In this study, we report the result of a quality improvement initiative targeted at improving adherence to ILPV guidelines in a large academic teaching hospital. METHODS: We performed a time-series study to determine whether anesthesia provider adherence to ILPV was affected by certain improvement interventions and patient ideal body weight (IBW)...
July 24, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28739535/importance-and-feasibility-of-transitional-care-for-children-with-medical-complexity-results-of-a-multi-stakeholder-delphi-process
#2
JoAnna K Leyenaar, Paul A Rizzo, Dmitry Khodyakov, Laurel K Leslie, Peter K Lindenauer, Rita Mangione-Smith
BACKGROUND: Children with medical complexity (CMC) account for disproportionate hospital utilization and adverse outcomes following discharge, and several gaps exist regarding the quality of hospital-to-home transitional care for this population. We conducted an expert elicitation process to identify important and feasible hospital-to-home transitional care interventions for CMC from the perspectives of parents and healthcare professionals. METHODS: We conducted a two-round electronic Delphi process to identify important and feasible transitional care interventions...
July 21, 2017: Academic Pediatrics
https://www.readbyqxmd.com/read/28739043/pocket-detection-and-interaction-weighted-ligand-similarity-search-yields-novel-high-affinity-binders-for-myocilin-olf-a-protein-implicated-in-glaucoma
#3
Bharath Srinivasan, Sam Tonddast-Navaei, Jeffrey Skolnick
Traditional structure and ligand based virtual screening approaches rely on the availability of structural and ligand binding information. To overcome this limitation, hybrid approaches were developed that relied on extraction of ligand binding information from proteins sharing similar folds and hence, evolutionarily relationship. However, they cannot target a chosen pocket in a protein. To address this, a pocket centric virtual ligand screening approach is required. Here, we employ a new, iterative implementation of a pocket and ligand-similarity based approach to virtual ligand screening to predict small molecule binders for the olfactomedin domain of human myocilin implicated in glaucoma...
July 12, 2017: Bioorganic & Medicinal Chemistry Letters
https://www.readbyqxmd.com/read/28734556/a-model-of-collaborative-spiritual-and-psychiatric-care-of-oncology-patients
#4
Larkin Elderon Kao, Hermioni N Lokko, Kathleen Gallivan, Vera O'Brien, John R Peteet
BACKGROUND: Many oncology patients see both chaplains and consultation-liaison (C-L) psychiatrists during medical hospitalizations. Studies show that spirituality and mental health influence one another, and that patients often prefer that physicians understand their spirituality. Though models of inpatient chaplaincy-psychiatry collaboration likely exist, none are apparent in the literature. In this study, we present one model of chaplaincy-psychiatry collaboration, hypothesizing that both specialties would find the intervention helpful...
June 23, 2017: Psychosomatics
https://www.readbyqxmd.com/read/28728205/-predictability-of-postoperative-pain-and-satisfaction-how-precise-are-we-and-what-is-the-role-of-professional-experience
#5
Ulf Krister Hofmann, Cosima Dobler, Marco Gesicki, Torsten Kluba, Sebastian Scheidt
Background The indication for surgery is justified by an expected improvement for the patient. To evaluate the probability and extent of individual postoperative patient benefit, the surgeon needs to elaborate numerous parameters of potential relevance for the outcome beyond his key competence, that is the technical dimension of the operation. Despite the highest medical standards, individual postoperative satisfaction with surgery is highly variable, even in cases with a technically good result. The aim of the present study was to investigate the individual predictability of postoperative pain and satisfaction in patients with elective musculoskeletal surgery...
July 20, 2017: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/28727386/retroperitoneal-access-for-robotic-renal-surgery
#6
Barrett G Anderson, Alec J Wright, Aaron M Potretzke, R Sherburne Figenshau
INTRODUCTION AND OBJECTIVE: Retroperitoneal access for robotic renal surgery is an effective alternative to the commonly used transperitoneal approach. We describe our contemporary experience and technique for attaining retroperitoneal access. MATERIALS AND METHODS: We outline our institutional approach to retroperitoneal access for the instruction of urologists at the beginning of the learning curve. The patient is placed in the lateral decubitus position. The first incision is made just inferior to the tip of the twelfth rib as described by Hsu, et al...
July 20, 2017: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/28718733/diagnostic-utility-of-renal-fine-needle-aspirate-cytology-and-ultrasound-in-the-cat
#7
Camille A McAloney, Leslie C Sharkey, Daniel A Feeney, Davis M Seelig
Objectives The primary objective of this study was to retrospectively assess the diagnostic utility of feline renal fine-needle aspiration cytology by assessing diagnostic yield, cytologic characteristics and diagnostic accuracy. The secondary objective was to characterize ultrasonographic features of sampled kidneys to determine if they influenced diagnostic yield. Methods Slides, images and patient data were collected from the University of Minnesota Veterinary Medical Center database. Slides were designated as diagnostic or non-diagnostic...
July 1, 2017: Journal of Feline Medicine and Surgery
https://www.readbyqxmd.com/read/28710589/primary-care-physician-perspectives-on-barriers-to-statin-treatment
#8
Rikki M Tanner, Monika M Safford, Keri L Monda, Benjamin Taylor, Ronan O'Beirne, Melanie Morris, Lisandro D Colantonio, Ricardo Dent, Paul Muntner, Robert S Rosenson
PURPOSE: Discontinuation of statin therapy represents a major challenge for effective cardiovascular disease prevention. It is unclear how often primary care physicians (PCPs) re-initiate statins and what barriers they encounter. We aimed to identify PCP perspectives on factors influencing statin re-initiation. METHODS: We conducted six nominal group discussions with 23 PCPs from the Deep South Continuing Medical Education network. PCPs answered questions about statin side effects, reasons their patients reported for discontinuing statins, how they respond when discontinuation is reported, and barriers they encounter in getting their patients to re-initiate statin therapy...
July 14, 2017: Cardiovascular Drugs and Therapy
https://www.readbyqxmd.com/read/28707548/geographical-assignment-of-hospitalists-in-an-urban-teaching-hospital-feasibility-and-impact-on-efficiency-and-provider-satisfaction
#9
Christine Bryson, Greta Boynton, Anna Stepczynski, Jane Garb, Reva Kleppel, Farzan Irani, Siva Natanasabathpy, Mihaela S Stefan
OBJECTIVE: To evaluate whether implementation of a geographic model of assigning hospitalists is feasible and sustainable in a large hospitalist program and assess its impact on provider satisfaction, perceived efficiency and patient outcomes. METHODS: Pre (3 months) - post (12 months) intervention study conducted from June 2014 through September 2015 at a tertiary care medical center with a large hospitalist program caring for patients scattered in 4 buildings and 16 floors...
July 14, 2017: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/28705913/interpretation-modalities-used-on-family-centered-rounds-perspectives-of-spanish-speaking-families
#10
Ashley Anttila, David I Rappaport, Johan Tijerino, Nusrat Zaman, Iman Sharif
BACKGROUND AND OBJECTIVES: Limited-English-proficient (LEP) patients and families are at risk for worse hospital outcomes due to impaired communication. Family-centered rounds (FCR) have become the preferred format for information sharing among providers and families at pediatric institutions. However, there are limited data on FCR among LEP families, particularly regarding interpretation type. We sought to examine the relationships between interpretation type and FCR satisfaction and efficacy among Spanish-speaking families, the fastest growing LEP population in pediatric hospitals...
July 13, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28702064/osseous-choristoma-of-submental-region-a-rare-occurrence
#11
Khushboo Sahay, Priyanka Kardam, Monica Mehendiratta, Shweta Rehani, Nisha Singh
Osseous choristoma is a rare, benign lesion of the oral cavity. This report presents a case of osseous choristoma in the submental region of a 30-year-old female subject. Her chief complaint was a painless swelling in the submental region. Panoramic radiography showed a well-defined, round, radiopaque lesion near the inferior border of the left mental region. The lesion was diagnosed as an osseous choristoma based on the histopathological examination of the surgical specimen. This paper is an attempt to bring forward a unique occurrence of osseous choristoma, which would further help the medical fraternity in improvising their knowledge, diagnosis, and treatment of this entity...
May 2017: Dental Research Journal
https://www.readbyqxmd.com/read/28700126/contextual-factors-impacting-a-pain-management-intervention
#12
Fawwaz Alaloul, Kimberly Williams, John Myers, Kayla Dlauren Jones, Katelyn Sullivan, M Cynthia Logsdon
PURPOSE: To determine if findings from our preliminary study related to patient and nursing satisfaction with a pain management intervention could be replicated in a changed environment, and if contextual factors could impact the effectiveness of a pain management intervention on patient satisfaction with nursing staff's management of pain. METHODS: A prospective, experimental design was used with six monthly assessments before, during, and after the intervention...
July 12, 2017: Journal of Nursing Scholarship
https://www.readbyqxmd.com/read/28699946/using-standardized-patients-to-assess-hospitalist-communication-skills
#13
Dennis Chang, Micah Mann, Terry Sommer, Robert Fallar, Alan Weinberg, Erica Friedman
Standardized patients (SPs) have been used to assess communication skills in undergraduate medical education, but no published studies describe the use of SPs in assessing practicing physicians on their communication skills. In this study, done with 23 hospitalists at a large urban academic hospital, 3 SP scenarios, daily rounding, discharge, and interacting with a difficult patient, were created. After each encounter, each hospitalist reviewed their videotape and received feedback from their SP based on a checklist that had 3 core domains: Listen, Courtesy and Respect, and Explain...
July 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28699939/implementing-acove-quality-indicators-as-an-intervention-checklist-to-improve-care-for-hospitalized-older-adults
#14
Liron Sinvani, Andrzej Kozikowski, Christopher Smilios, Vidhi Patel, Guang Qiu, Meredith Akerman, Martin Lesser, David Rosenberg, Gisele Wolf-Klein, Renee Pekmezaris
BACKGROUND: Medicare patients account for approximately 50% of hospital days. Hospitalization in older adults often results in poor outcomes. OBJECTIVE: To test the feasibility and impact of using Assessing Care of Vulnerable Elders (ACOVE) quality indicators (QIs) as a therapeutic intervention to improve care of hospitalized older adults. DESIGN: >Post-test only prospective intervention with a nonequivalent retrospective control group...
July 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28699937/techniques-and-behaviors-associated-with-exemplary-inpatient-general-medicine-teaching-an-exploratory-qualitative-study
#15
Nathan Houchens, Molly Harrod, Stephanie Moody, Karen Fowler, Sanjay Saint
BACKGROUND: Clinician educators face numerous obstacles to their joint mission of facilitating high-quality learning while also delivering patient-centered care. Such challenges necessitate increased attention to the work of exemplary clinician educators, their respective teaching approaches, and the experiences of their learners. OBJECTIVE: To describe techniques and behaviors utilized by clinician educators to facilitate excellent teaching during inpatient general medicine rounds...
July 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28693524/national-consensus-on-communication-in-prehospital-trauma-care-the-denim-study
#16
Annelieke Maria Karien Harmsen, Leo Maria George Geeraedts, Georgios Fredericus Giannakopoulos, Maartje Terra, Herman M T Christiaans, Lidwine Brigitta Mokkink, Frank Willem Bloemers
BACKGROUND: In the Netherlands prehospital trauma care is provided by emergency medical services (EMS) nurses. This care is extended by Physician staffed Helicopter Emergency Medical Services (P-HEMS) for the more severely injured patient. Prehospital communication is a factor of influence on the identification of these patients and the dispatch of P-HEMS. Though prehospital communication it is often perceived to be incomplete and unstructured. To elucidated factors of influence on prehospital triage and the identification of the severely injured patient a Delphi study was performed...
July 11, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28693066/-fifth-chinese-national-consensus-report-on-the-management-of-helicobacter-pylori-infection
#17
G Liu, J Xie, Z R Lu, L Y Cheng, Y Zeng, J B Zhou, Y J Chen, N H Wang, Yiqi Du, Nonghua Lyu
The fifth national consensus conference on the management of Helicobacter pylori (H.pylori) infection organized by Chinese Medical Association, Chinese Society of Gastroenterology, H. pylori and Peptic Ulcer Study Group was held at Hangzhou, Zhejiang Province on December 15-16, 2016.More than 80 members of the study group and experts in the field of H. pylori research and gastroenterology attended the meeting.Consensus preparatory group was established to draft the related statements.The quality of evidence and strength of recommendation were evaluated by GRADE system...
July 1, 2017: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/28693056/-the-clinical-characteristics-of-pulmonary-benign-metastasizing-leiomyoma
#18
H P Wang, J H Shi, L Zhang
Objective: Pulmonary benign metastasizing leiomyoma (PBML) is a rare entity that leiomyoma of uterus metastasized to the lung. The clinical characteristics of this rare disease were analyzed in this article. Methods: The detailed clinical records of 7 patients diagnosed as PBML at Peking Union Medical College Hospital between January 2001 and June 2015 were reviewed. Results: All patients were women with median age of 44 years (range 28-62). Symptoms included dyspnea (2/7), chest pain (1/7), cyanosis (1/7), cough (1/7) and bloody sputum (1/7), while 4/7 cases were asymptomatic...
July 1, 2017: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/28687048/a-core-undergraduate-curriculum-in-plastic-surgery-a-delphi-consensus-study-in-scandinavia
#19
Stian K Almeland, Andrew Lindford, Jais Oliver Berg, Emma Hansson
BACKGROUND AND AIMS: In recent years, undergraduate medical education has undergone a transition from a speciality-based to a more competence-based training system. Consequently, whilst medical knowledge is rapidly expanding, time for teaching of the surgical specialties is decreasing. Thus, there appears to be a need to define the core competences that are to be taught. The aim of this study was to establish a Scandinavian core undergraduate curriculum of competences in plastic surgery, using scientific methods...
July 7, 2017: Journal of Plastic Surgery and Hand Surgery
https://www.readbyqxmd.com/read/28686486/exploring-challenges-in-the-patient-s-discharge-process-from-the-internal-medicine-service-a-qualitative-study-of-patients-and-providers-perceptions
#20
Vincent Pinelli, Heather L Stuckey, Jed D Gonzalo
In hospital-based medicine units, patients have a wide range of complex medical conditions, requiring timely and accurate communication between multiple interprofessional providers at the time of discharge. Limited work has investigated the challenges in interprofessional collaboration and communication during the patient discharge process. In this study, authors qualitatively assessed the experiences of internal medicine providers and patients about roles, challenges, and potential solutions in the discharge process, with a phenomenological focus on the process of collaboration...
July 7, 2017: Journal of Interprofessional Care
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