The Relationship Between Patient Follow-Up and Deliberate Practice in Emergency Medicine Education: A Review of the Literature

Long-term effects of tracheostomy can include structural changes in the anterior tracheal wall and larynx as a result of pressure, friction, and deformation by the relationship between the curved cannula, the trachea, the larynx, and the upper border of the sternum. High-placed stoma, flexed cervical position, and short, obese necks are predisposing anatomic relationships, in some long-standing tracheostomies, progressive erosion of the upper anterior tracheal wall and cricoid arch is observed, often with secondary subglottic stenosis. No discussion of measures to prevent or correct these problems was found in a review of the literature. This article discusses surgical techniques to (1) prevent laryngotracheal erosion and (2) repair and reconstruct an airway that is already damaged. A superiorly based tracheostomy flap and a muscular sling are designed to buttress the tracheostomy. Results and follow-up are also reported.

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Relationship between Thyroglobulin and Tumor Detectabilily with Thallium-201 in Differentiated Thyroid Cancer

Nuklearmedizin ◽

10.1055/s-0038-1632238 ◽

2000 ◽

Vol 39 (01) ◽

pp. 10-15 ◽

Cited By ~ 1

Author(s):

S. P. Müller ◽

Ch. Reiners ◽

A. Bockisch ◽

Katja Brandt-Mainz

Keyword(s):

Thyroid Cancer ◽

Differentiated Thyroid Cancer ◽

Roc Analysis ◽

Tsh Suppression ◽

Significant Difference ◽

Test Specificity ◽

The Relationship ◽

Tumor Scintigraphy ◽

Tsh Stimulation

Summary Aim: Tumor scintigraphy with 201-TICI is an established diagnostic method in the follow-up of differentiated thyroid cancer. We investigated the relationship between thyroglobulin (Tg) level and tumor detectability. Subject and methods: We analyzed the scans of 122 patients (66 patients with proven tumor). The patient population was divided into groups with Tg above (N = 33) and below (N = 33) 5 ng/ml under TSH suppression or above (N = 33) and below (N = 33) 50 ng/ml under TSH stimulation. Tumor detectability was compared by ROC-analysis (True-Positive-Fraction test, specificity 90%). Results: There was no significant difference (sensitivity 75% versus 64%; p = 0.55) for patients above and below 5 ng/ml under TSH suppression and a just significant difference (sensitivity 80% versus 58%; p = 0.04) for patients above and below 50 ng/ml under TSH stimulation. In 18 patients from our sample with tumor, Tg under TSH suppression was negative, but 201-TICI-scan was able to detect tumor in 12 patients. Conclusion: Our results demonstrate only a moderate dependence of tumor detectability on Tg level, probably without significant clinical relevance. Even in patients with slight Tg elevation 201-TICI scintigraphy is justified.

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Pneumomediastinum: A Rare Presentation of Inflicted Injuries in Infants

Journal of Pediatric Intensive Care ◽

10.1055/s-0040-1716857 ◽

2020 ◽

Author(s):

Adam Lee ◽

Adam Bajinting ◽

Abby Lunneen ◽

Colleen M. Fitzpatrick ◽

Gustavo A. Villalona

Keyword(s):

Literature Review ◽

Retrospective Review ◽

Review Of The Literature ◽

Rare Presentation ◽

Spontaneous Pneumomediastinum ◽

Nonaccidental Trauma ◽

Comprehensive Literature Review ◽

Healthy Infants ◽

History Of

AbstractReports of incidental pneumomediastinum in infants secondary to inflicted trauma are limited. A retrospective review of infants with pneumomediastinum and history of inflicted trauma was performed. A comprehensive literature review was performed. Three infants presented with pneumomediastinum associated with inflicted trauma. Mean age was 4.6 weeks. All patients underwent diagnostic studies, as well as a standardized evaluation for nonaccidental trauma. All patients with pneumomediastinum were resolved at follow-up. Review of the literature identified other cases with similar presentations with related oropharyngeal injuries. Spontaneous pneumomediastinum in previously healthy infants may be associated with inflicted injuries. Clinicians should be aware of the possibility of an oropharyngeal perforation related to this presentation.

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Hydrocephalus in Spinal Muscular Atrophy: A Case Report and Review of the Literature

Journal of Pediatric Neurology ◽

10.1055/s-0040-1721131 ◽

2020 ◽

Author(s):

Jeetendra P. Sah ◽

Aaron W. Abrams ◽

Geetha Chari ◽

Craig Linden ◽

Yaacov Anziska

Keyword(s):

Spinal Muscular Atrophy ◽

Clinical Characteristics ◽

Clinical Presentation ◽

Muscular Atrophy ◽

Communicating Hydrocephalus ◽

Type I ◽

Review Of The Literature ◽

Radiographic Findings ◽

Comprehensive Review ◽

The Relationship

AbstractIn this article, we reported a case of spinal muscular atrophy (SMA) type I noted to have tetraventricular hydrocephalus with Blake's pouch cyst at 8 months of age following intrathecal nusinersen therapy. The association of hydrocephalus with SMA is rarely reported in the literature. Development of hydrocephalus after intrathecal nusinersen therapy is also reported in some cases, but a cause–effect relationship is not yet established. The aim of this study was to describe the clinical characteristics of a patient with SMA type I and hydrocephalus, to review similar cases reported in the literature, and to explore the relationship between nusinersen therapy and development of hydrocephalus. The clinical presentation and radiographic findings of the patient are described and a comprehensive review of the literature was conducted. The adverse effect of communicating hydrocephalus related to nusinersen therapy is being reported and the authors suggest carefully monitoring for features of hydrocephalus developing during the course of nusinersen therapy.

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A Decade of Disparities in Diabetes Technology Use and HbA1c in Pediatric Type 1 Diabetes: A Trans-Atlantic Comparison

10.2337/figshare.12808301 ◽

2020 ◽

Author(s):

Ananta Addala ◽

Marie Auzanneau ◽

Kellee Miller ◽

Werner Maier ◽

Nicole Foster ◽

...

Keyword(s):

Type 1 Diabetes ◽

Technology Use ◽

Hemoglobin A1c ◽

Diabetes Technology ◽

Design And Methods ◽

Relationship Of ◽

The Relationship ◽

Pediatric Type 1 Diabetes

Objective: As diabetes technology use in youth increases worldwide, inequalities in access may exacerbate disparities in hemoglobin A1c (HbA1c). We hypothesized an increasing gap in diabetes technology use by socioeconomic status (SES) would be associated with increased HbA1c disparities. Research Design and Methods: Participants aged <18 years with diabetes duration ≥1 year in the Type 1 Diabetes Exchange (T1DX, US, n=16,457) and Diabetes Prospective Follow-up (DPV, Germany, n=39,836) registries were categorized into lowest (Q1) to highest (Q5) SES quintiles. Multiple regression analyses compared the relationship of SES quintiles with diabetes technology use and HbA1c from 2010-2012 and 2016-2018. Results: HbA1c was higher in participants with lower SES (in 2010-2012 & 2016-2018, respectively: 8.0% & 7.8% in Q1 and 7.6% & 7.5% in Q5 for DPV; and 9.0% & 9.3% in Q1 and 7.8% & 8.0% in Q5 for T1DX). For DPV, the association between SES and HbA1c did not change between the two time periods, whereas for T1DX, disparities in HbA1c by SES increased significantly (p<0.001). After adjusting for technology use, results for DPV did not change whereas the increase in T1DX was no longer significant. Conclusions: Although causal conclusions cannot be drawn, diabetes technology use is lowest and HbA1c is highest in those of the lowest SES quintile in the T1DX and this difference for HbA1c broadened in the last decade. Associations of SES with technology use and HbA1c were weaker in the DPV registry.

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External Investigators' Follow-Up Intentions When Whistleblowers Report Healthcare Fraud: The Effects of Report Anonymity and Previous Confrontation

Behavioral Research in Accounting ◽

10.2308/bria-19-042 ◽

2020 ◽

Vol 32 (2) ◽

pp. 91-101

Author(s):

Steven E. Kaplan ◽

Danny Lanier ◽

Kelly R. Pope ◽

Janet A. Samuels

Keyword(s):

Experimental Study ◽

Early Detection ◽

Data Availability ◽

Medical Provider ◽

Perceived Credibility ◽

The Relationship ◽

Critical Investigation

ABSTRACT Whistleblowing reports, if properly investigated, facilitate the early detection of fraud. Although critical, investigation-related decisions represent a relatively underexplored component of the whistleblowing process. Investigators are responsible for initially deciding whether to follow-up on reports alleging fraud. We report the results of an experimental study examining the follow-up intentions of highly experienced healthcare investigators. Participants, in the role of an insurance investigator, are asked to review a whistleblowing report alleging billing fraud occurring at a medical provider. Thus, participants are serving as external investigators. In a between-participant design, we manipulate the report type and whether the caller previously confronted the wrongdoer. We find that compared to an anonymous report, a non-anonymous report is perceived as more credible and follow-up intentions stronger. We also find that perceived credibility fully mediates the relationship between report type and follow-up intentions. Previous confrontation is not significantly associated with either perceived credibility or follow-up intentions. Data Availability: Data are available upon request.

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Intramedullary Teratoma: Case Report and Review of the Literature

Tumori Journal ◽

10.1177/030089169608200622 ◽

1996 ◽

Vol 82 (6) ◽

pp. 616-620 ◽

Cited By ~ 18

Author(s):

Riccardo Caruso ◽

Mariano Antonelli ◽

Luigi Cervoni ◽

Maurizio Salvati

Keyword(s):

Case Report ◽

Surgical Removal ◽

International Literature ◽

Review Of The Literature ◽

Personal Case

Aims and Background Intramedullary teratoma is an extremely exceptional tumor (5 cases), although a careful review of international literature has shown it to be more frequent (32 cases) than believed. Methods The authors present a personal case with some unusual aspects. Results Our case is unusual not only because it was diagnosed by MRI (only one case has been reported in the literature) but also because surgical removal of the tumor was apparently total (only 4 other cases have been described), with a long follow-up period (4.5 years) and excellent results, in clinical and neuroradiologic terms.

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Characteristics of Different Types of Childhood Violence and the Risk of Revictimization

Violence Against Women ◽

10.1177/1077801218818381 ◽

2019 ◽

Vol 25 (14) ◽

pp. 1696-1716 ◽

Cited By ~ 4

Author(s):

Ida Frugaard Stroem ◽

Helene Flood Aakvaag ◽

Tore Wentzel-Larsen

Keyword(s):

Childhood Abuse ◽

Telephone Survey ◽

Regression Analyses ◽

Multiple Forms ◽

Different Types ◽

Children And Young Adults ◽

Childhood Violence ◽

Forms Of Violence ◽

The Relationship

This study investigates the relationship between the characteristics of different types of childhood violence and adult victimization using two waves of data from a community telephone survey (T1) and a follow-up survey, including 505 cases and 506 controls, aged 17-35 years (T2). The logistic regression analyses showed that exposure to childhood abuse, regardless of type, was associated with adult victimization. Exposure to multiple types of abuse, victimization both in childhood and in young adulthood, and recency of abuse increased these odds. Our findings emphasize the importance of assessing multiple forms of violence when studying revictimization. Practitioners working with children and young adults should be attentive to the number of victimization types experienced and recent victimization to prevent further abuse.

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Clinical Evaluation of the Variables associated with Treatment Acceptability and Their Relation to Compliance

Behavioral Disorders ◽

10.1177/019874299201800108 ◽

1992 ◽

Vol 18 (1) ◽

pp. 67-76 ◽

Cited By ~ 36

Author(s):

Thomas M. Reimers ◽

David P. Wacker ◽

Linda J. Cooper ◽

Agnes O. Deraad

Keyword(s):

Behavior Problem ◽

Behavior Management ◽

Positive Reinforcement ◽

Treatment Acceptability ◽

Clinic Visit ◽

Future Research ◽

Parental Ratings ◽

Problem Severity ◽

The Relationship

The authors examined the acceptability ratings of positive reinforcement procedures recommended to parents seen in a pediatric behavior management outpatient clinic. Parental ratings of acceptability were obtained in the clinic and 1, 3, and 6 months following their initial clinic visit. Acceptability variables were examined by group (parents who rated the acceptability of treatments as high vs. low) and by severity (parents who rated their children's behavior problem as severe vs. mild). The relationship between these variables and reported compliance was also examined. Results show that the acceptability variables were useful in differentiating between parents who rated treatments to be more acceptable and parents who rated treatments to be less acceptable. Differences were also observed as a function of behavior problem severity. Significant correlations occurred between acceptability variables and compliance at each of the follow-up points. Results are discussed in relation to the clinical significance of these findings and the impetus they might serve for future research.

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Acute Dental Periapical Abscess and New-Onset Atrial Fibrillation: A Nationwide, Population-Based Cohort Study

Journal of Clinical Medicine ◽

10.3390/jcm10132927 ◽

2021 ◽

Vol 10 (13) ◽

pp. 2927

Author(s):

Amaar Obaid Hassan ◽

Gregory Y. H. Lip ◽

Arnaud Bisson ◽

Julien Herbert ◽

Alexandre Bodin ◽

...

Keyword(s):

Atrial Fibrillation ◽

Cohort Study ◽

Multivariable Analysis ◽

National Database ◽

Increased Risk ◽

Periapical Abscess ◽

The Relationship ◽

Onset Atrial Fibrillation ◽

New Onset

There are limited data on the relationship of acute dental infections with hospitalisation and new-onset atrial fibrillation (AF). This study aimed to assess the relationship between acute periapical abscess and incident AF. This was a retrospective cohort study from a French national database of patients hospitalized in 2013 (3.4 million patients) with at least five years of follow up. In total, 3,056,291 adults (55.1% female) required hospital admission in French hospitals in 2013 while not having a history of AF. Of 4693 patients classified as having dental periapical abscess, 435 (9.27%) developed AF, compared to 326,241 (10.69%) without dental periapical abscess that developed AF over a mean follow-up of 4.8 ± 1.7 years. Multivariable analysis indicated that dental periapical abscess acted as an independent predictor for new onset AF (p < 0.01). The CHA2DS2VASc score in patients with acute dental periapical abscess had moderate predictive value for development of AF, with Area Under the Curve (AUC) 0.73 (95% CI, 0.71–0.76). An increased risk of new onset AF was identified for individuals hospitalized with dental periapical abscess. Careful follow up of patients with severe, acute dental periapical infections is needed for incident AF, as well as investigations of possible mechanisms linking these conditions.

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