scholarly journals Is Call Karma Real? Resident After-Hours On-Call Imaging at the University of Saskatchewan: An Assessment of Call Volumes Including Inter-Resident Variability

2021 ◽  
pp. 084653712110263
Author(s):  
James Huynh ◽  
David Horne ◽  
Rhonda Bryce ◽  
David A Leswick
Keyword(s):  
Mean Shift ◽  
Mean Values ◽  
Body Regions ◽  
Time Period ◽  
Relative Value ◽  
Number Of Patients ◽  
After Hours ◽  
Disproportionate Number ◽  
The University ◽  
Changes Over Time

Purpose: Quantify resident caseload during call and determine if there are consistent differences in call volumes for individuals or resident subgroups. Methods: Accession codes for after-hours computed tomography (CT) cases dictated by residents between July 1, 2012 and January 9, 2017 were reviewed. Case volumes by patient visits and body regions scanned were determined and categorized according to time period, year, and individual resident. Mean shift Relative Value Units (RVUs) were calculated by year. Descriptive statistics, linear mixed modeling, and linear regression determined mean values, differences between residents, associations between independent variables and outcomes, and changes over time. Consistent differences between residents were assessed as a measure of good or bad luck / karma on call. Results: During this time there were 23,032 patients and 30,766 anatomic regions scanned during 1,652 call shifts among 32 residents. Over the whole period, there were on average 10.6 patients and 14.3 body regions scanned on weekday shifts and 22.3 patients and 29.4 body regions scanned during weekend shifts. Annually, the mean number of patients, body regions, and RVUs scanned per shift increased by an average of 0.2 (1%), 0.4 (2%), and 1.2 (5%) (all p < 0.05) respectively in regression models. There was variability in call experiences, but only 1 resident had a disproportionate number of higher volume calls and fewer lower volume shifts than expected. Conclusions: Annual increases in scan volumes were modest. Although residents’ experiences varied, little of this was attributable to consistent personal differences, including luck or call karma.

scholarly journals Evaluation of Emerging Antimicrobials Resistance in nosocomial infections caused by E. coli: The comparison results of observed cases and compartmental model

2021 ◽  
Author(s):  
mohammad kogani ◽  
babak eshrati ◽  
hamid reza baradaran ◽  
leila janani ◽  
mahshid nasehii
Keyword(s):  
Nosocomial Infections ◽  
Compartmental Model ◽  
Study Data ◽  
World Health ◽  
E Coli ◽  
Time Period ◽  
Comparison Results ◽  
Number Of Patients ◽  
Health Organization ◽  
The University

Abstract Background Early detection of Antimicrobials Resistance outbreaks is one of the most important goals of the World Health Organization. In this study, by comparing the observed cases of resistance with its expected cases, the outbreak of these resistances was investigated. It should be noted that this subject was not done in the country until the time of the study. Methods This study is a hospital-based study. Data related to all the university general of Iran (57 hospitals) were used. In these hospitals, all the patients who were infected by E.coli in time period of March 21 2017 to March 20 2018 were enrolled in the study. Then, using an index called the SIR; the observed cases of resistant E.coli were compared with the expected ones. This index is achieved from dividing the observed cases by its expected cases. If the obtained number is greater than one, it indicates the greater observed cases rather than the expected cases, which can represent Emerging. In order to compute SIR index, we divided the number of observed cases of Antimicrobials Resistance E.coli by the number of expected cases of each Antimicrobials Resistance E coli. To predict the expected cases of each Antimicrobials Resistance E coli, we developed one compartmental model. In this model, the number of patients is estimated using equations. Berkeley Madonna version 8.3.23 software was used to manipulate these equations. Results The SIR index for E.coli resistant to Ampicillin, Ceftazidime and Colistin were 1.2(1.1–1.3), 1.1(1.02–1.2) and 1.7(1.02–2.3) respectively. This index for E.coli resistant to Meropenem was .8 (.6-.9). In other cases, the calculated index was not statistically significant. Conclusions Ampicillin-resistant E.coli and Ceftazidime-resistant E.coli observed cases among nosocomial infections were greater than the expected cases. Hence it is necessary to reconsider using such type of antibiotics in treatment of nosocomial infections caused by E.coli. The results of this study could be important for health policy makers. In the future, outbreaks of this type of infection can be investigated with the help of the results of this study.

The ENT emergency clinic: does senior input matter?

2012 ◽  
Vol 127 (1) ◽  
pp. 15-19 ◽  
Author(s):  
A Mirza ◽  
L McClelland ◽  
M Daniel ◽  
N Jones
Keyword(s):  
Quality Of Care ◽  
Discharge Rate ◽  
Surrogate Marker ◽  
Operating Theatre ◽  
Number Of Children ◽  
Discharge Rates ◽  
Time Period ◽  
Number Of Patients

AbstractBackground:Many ENT conditions can be treated in the emergency clinic on an ambulatory basis. Our clinic traditionally had been run by foundation year two and specialty trainee doctors (period one). However, with perceived increasing inexperience, a dedicated registrar was assigned to support the clinic (period two). This study compared admission and discharge rates for periods one and two to assess if greater registrar input affected discharge rate; an increase in discharge rate was used as a surrogate marker of efficiency.Method:Data was collected prospectively for patients seen in the ENT emergency clinic between 1 August 2009 and 31 July 2011. Time period one included data from patients seen between 1 August 2009 and 31 July 2010, and time period two included data collected between 1 August 2010 and 31 July 2011.Results:The introduction of greater registrar support increased the number of patients that were discharged, and led to a reduction in the number of children requiring the operating theatre.Conclusion:The findings, which were determined using clinic outcomes as markers of the quality of care, highlighted the benefits of increasing senior input within the ENT emergency clinic.

scholarly journals Emergency medical services evaluations for chest pain during first COVID-19 lockdown in Hollands-Midden, the Netherlands

2021 ◽  
Vol 29 (4) ◽  
pp. 224-229 ◽  
Author(s):  
E. R. de Koning ◽  
M. J. Boogers ◽  
J. Bosch ◽  
M. de Visser ◽  
M. J. Schalij ◽  
...  
Keyword(s):  
Chest Pain ◽  
Emergency Medical Services ◽  
Medical Services ◽  
Cardiac Symptoms ◽  
Emergency Medical ◽  
Time Period ◽  
Number Of Patients ◽  
St Elevation ◽  
Pain Patients ◽  
Hospital Cardiac Arrest

Abstract Objective To assess whether the COVID-19 lockdown in 2020 had negative indirect health effects, as people seem to have been reluctant to seek medical care. Methods All emergency medical services (EMS) transports for chest pain or out-of-hospital cardiac arrest (OHCA) in the Dutch region Hollands-Midden (population served > 800,000) were evaluated during the initial 6 weeks of the COVID-19 lockdown and during the same time period in 2019. The primary endpoint was the number of evaluated chest pain patients in both cohorts. In addition, the number of EMS evaluations of ST-elevation myocardial infarction (STEMI) and OHCA were assessed. Results During the COVID-19 lockdown period, the EMS evaluated 927 chest pain patients (49% male, age 62 ± 17 years) compared with 1041 patients (51% male, 63 ± 17 years) in the same period in 2019, which corresponded with a significant relative risk (RR) reduction of 0.88 (95% confidence interval (CI) 0.81–0.96). Similarly, there was a significant reduction in the number of STEMI patients (RR 0.52, 95% CI 0.32–0.85), the incidence of OHCA remained unchanged (RR 1.23, 95% CI 0.83–1.83). Conclusion During the first COVID-19 lockdown, there was a significant reduction in the number of patients with chest pain or STEMI evaluated by the EMS, while the incidence of OHCA remained similar. Although the reason for the decrease in chest pain and STEMI consultations is not entirely clear, more attention should be paid to the importance of contacting the EMS in case of suspected cardiac symptoms in possible future lockdowns.

scholarly journals Impact of the COVID-19 pandemic and its related psychological effect on orthopedic surgeries conducted in different types of hospitals in Taiwan

2021 ◽  
Vol 29 (1) ◽  
pp. 230949902199607 ◽  
Author(s):  
Chia-Lung Shih ◽  
Peng-Ju Huang ◽  
Hsuan-Ti Huang ◽  
Chung-Hwan Chen ◽  
Tien-Ching Lee ◽  
...  
Keyword(s):  
Community Hospital ◽  
University Hospital ◽  
Total Knee Arthroplasties ◽  
Peak Period ◽  
Number Of Patients ◽  
Total Knee ◽  
Investigation Period ◽  
Orthopedic Diseases ◽  
The University ◽  
The Impact

Aim: Taiwan’s response to the coronavirus disease 2019 (COVID-19) differed in that it successfully prevented the spread without having to shutdown or overburden medical services. Patients’ fear regarding the pandemic would be the only reason to reduce surgeries, so Taiwan could be the most suitable place for research on the influence of psychological factors. This study aimed to assess the impact of patients’ fear on orthopedic surgeries in Taiwan amid the peak period of the COVID-19 pandemic. Patients and Methods: The investigation period included the COVID-19 pandemic (March 2020 to April 2020) and the corresponding period in the previous year. The following data on patients with orthopedic diseases were collected: outpatient visits, hospital admission, and surgical modalities. Results: The COVID-19 pandemic led to a 22%–29% and 20%–26% reduction in outpatients, 22%–27% and 25%–37% reduction in admissions, and 26%–35% and 18%–34% reduction in surgeries, respectively, at both hospitals. The weekly mean number of patients was significantly smaller during the COVID-19 pandemic for all types of surgery and elective surgeries at the university hospital, and for all types of surgery, elective surgeries, and total knee arthroplasties at the community hospital. Further, patients visiting the community hospital during the pandemic were significantly younger, for all types of surgery, elective surgeries, and total knee arthroplasties. Conclusions: The reduction in orthopedic surgeries in Taiwan’s hospitals during COVID-19 could be attributed to patients’ fear. Even without restriction, the pandemic inevitably led to a reduction of about 20%–30% of the operation volume.

Physiological Assessment of Bagpipers: A Preliminary Study of Cardiopulmonary Parameters

2000 ◽  
Vol 15 (2) ◽  
pp. 51-54
Author(s):  
Deborah Barr ◽  
Lee Van Dusen ◽  
Steve Ess ◽  
Julie Plezbert
Keyword(s):  
Heart Rate ◽  
Repeated Measures ◽  
Vital Capacity ◽  
A Priori ◽  
Mean Values ◽  
Time Period ◽  
Impedance Cardiograph ◽  
Cardiac Adaptation ◽  
Automatic Blood Pressure ◽  
Predicted Values

This study examined pulmonary function of pipers and cardiac adaptation to the playing of the Great Highland bagpipe. Pipers (n = 13) of varying ages (31-65 years) and playing experiences (2-20+ years) were evaluated for vital capacity (VC), maximal voluntary ventilation (MVV), and forced vital capacity (FVC) using a RIKO AS-600 spirometer. Subjects were monitored by impedance cardiograph for heart rate (HR), stroke volume (SV), and cardiac output (CO) at rest and during 5 minutes of playing. An automatic blood pressure (BP) monitor collected BP values over the same time period. Eleven weeks after initial cardiac data collection, the BP and cardiac measurements were repeated using the same protocols. Mean values for HR, SV, and CO were calculated for rest and each minute (1-5) of playing. A 2 (data session) by 6 (rest, min 1–5) repeated-measures ANOVA was performed. Analysis revealed a significant overall time effect (p < 0.001) on HR. A-priori contrast comparing all playing times with rest showed significant differences at all time points. Analysis of SV and CO failed to find significance. Heart rate values calculated for percent of maximum ranged from 68% to 89% of maximum overall while playing (session 1) and from 55% to 81% of maximum (session 2). Predicted percent of maximum values for VC and MVV found 77% of players above their maximum predicted values.

Abstract WP374: Implementation of the Stroke Transition Discharge Center Improves 30-day Readmission Rate

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Susan Quimby ◽  
Javicia Peterson-Cole
Keyword(s):  
Readmission Rate ◽  
Inverse Correlation ◽  
Signs And Symptoms ◽  
Patient Specific ◽  
Readmission Rates ◽  
Hospital System ◽  
Practice Nurses ◽  
Time Period ◽  
Number Of Patients ◽  
Discharge Center

Background: Stroke patients and their caregivers require formalized education, medications, testing and rehabilitation to assist in prevention of recurrence and of post-stroke complications for optimal outcomes. Objective: The purpose of this program was to evaluate the effect of the Stroke Transition Discharge Center (STDC) on stroke readmission. Methods: The Advanced Practice Nurses (APN) see all stroke and TIA patients one week after discharge from hospital to home or one week after discharge from rehab to home. During the hour encounter, the APN reviews medications, test results, signs and symptoms of stroke, complete education including patient specific risk factors and ensure appropriate follow up. The APN coordinates and facilitates multiple services and disciplines impacting the patient, assuring the most efficient and effective goal-directed activities are provided at the right time and in partnership with all other disciplines providing care. Results: Implementation of the STDC enhances patient outcomes and improves 30-day readmission rates. Prior to our intervention, the readmission rate was 15.3%. After the implementation of the STDC, there was a 61% reduction in 30-day readmission rates to 6%, which is significantly below the hospital system benchmark of 11%. There was an increase in the readmission rate in the first two quarters of 2016 noted. There is an inverse correlation with the number of patients seen in the STDC during the same time period. Further analysis demonstrates that only one readmission in this time period had been seen prior in the STDC. Conclusion: Implementing the Stroke Transition Discharge Center demonstrated a dramatic reduction in 30-day readmission rates. Our data suggests that utilization of the clinic and participation by the patients has a direct and inverse effect on readmissions. Further data will need to be collected to determine if this is a sustained response.

Maternal care and environmental enrichment influences on serotonin knockout mice with implications for a gene x stress model of autism

2019 ◽  
Author(s):  
◽  
Briana M. Kille
Keyword(s):  
Serotonin Transporter ◽  
Maternal Care ◽  
Environmental Enrichment ◽  
Environmental Influence ◽  
Repetitive Behavior ◽  
Critical Time ◽  
University Of Missouri ◽  
Time Period ◽  
Maternal Genotype ◽  
The University

[ACCESS RESTRICTED TO THE UNIVERSITY OF MISSOURI AT REQUEST OF AUTHOR.] Previous research has shown a genetic variant in the serotonin transporter gene (Slc6a4) can increase the severity of a person's reaction to stress. This variant interacts with environmental stressors resulting in poorer health outcomes. Previous studies have also found that stressing pregnant mothers who carry the variant can result in an increased likelihood of autism diagnosis for the child. This maternal genotype x prenatal stress interaction has been modeled in the serotonin transporter knockout (SERT KO) mouse--dams genetically modified to mimic humans carrying the short allele were stressed during pregnancy resulting in offspring showing altered social behavior, repetitive behavior, and anxiety behavior. The first study included in this dissertation attempted to replicate this model while using a foster dam paradigm to avoid potential maternal care confounds. Surprisingly, the results showed that equalizing maternal care equalized several group differences in behavior. It is theorized that this is due to elimination of the neonatal insult from poor maternal care that would correspond to a human prenatal insult during a previously identified critical time period. The second study explored the potential effects environmentally enriched home cages on anxiety like behaviors of SERT KO mice. The study showed that all animals, regardless of genotype, showed fewer anxiety like behaviors in the open field assay. Together, these studies expand on our understanding of environmental influence on SERT KO mice used in translational studies.

Neoglottic Reconstruction following Total Laryngectomy

1980 ◽  
Vol 89 (6) ◽  
pp. 534-537 ◽  
Author(s):  
Bruce Leipzig
Keyword(s):  
Total Laryngectomy ◽  
Operative Procedure ◽  
Careful Study ◽  
Texas Medical ◽  
University Of Texas ◽  
Major Complications ◽  
Number Of Patients ◽  
Constant Feature ◽  
Gag Reflex ◽  
The University

The purpose of this paper is to analyze the problems and complications which have resulted from neoglottic reconstruction at the University of Texas Medical Branch in Galveston. It has been performed as a primary procedure at the time of laryngectomy on 50 patients. Over 40 % of these patients have required a second operative procedure to control major complications of their neoglottis. Aspiration is a nearly constant feature of the procedure, and a significant number of patients do not tolerate it well. Radiation therapy does not appear to increase the number of problems, but the complications are more severe when they do occur, and they are more difficult to control. The indications for surgical neoglottic reconstruction cannot be extended beyond those tumors which are within the confines of the larynx without an increased incidence of major complications. Other relative contraindications to this surgery are poor patient pulmonary reserve, reflux esophageal incompetence, and a “hyperactive” gag reflex. Nine patients with prior treatment which included a total laryngectomy underwent secondary neoglottic reconstruction. In our experience, all have had significant aspiration. About one half of these patients developed speech. The procedure of neoglottic reconstruction must be reviewed critically prior to popular introduction into the surgical armamentarium. A plea for careful study by a small number of experienced surgeons is now in order.

scholarly journals Prevalence of Traumatic Dental Injuries in Patients Attending University of Alberta Emergency Clinic

2016 ◽  
Vol 10 (1) ◽  
pp. 315-321 ◽  
Author(s):  
Thamer Alkhadra ◽  
William Preshing ◽  
Tarek El-Bialy
Keyword(s):  
Alveolar Bone ◽  
Dental Trauma ◽  
Class Iii ◽  
Root Fracture ◽  
University Of Alberta ◽  
Number Of Patients ◽  
Dentoalveolar Trauma ◽  
Traumatic Dental Injuries ◽  
The University ◽  
Dental Injuries

Objectives:This study evaluated the prevalence of dental trauma for patients attending the emergency dental clinic at the University of Alberta Hospital between 2006-2009. Patients’ examination and treatment charts were reviewed.Methods:Total number of patients’ charts was 1893.The prevalence of different types of trauma was 6.4 % of the total cases (117 patients). Trauma cases were identified according to Ellis classification and as modified by Hollandet al.,1988.Results:Logistic statistical model showed that 21.7% were Ellis class I trauma, 16.7% were Ellis class II trauma, and 6.7% were Ellis class III. In addition, 11.7 % presented with avulsion, 7.5 % presented with dentoalveolar fracture and 7.5% presented with sublaxation. Also, 17.55 % presented with tooth displacement within the alveolar bone, 3.3 % presented with crown fracture with no pulp involvement, 4.16 % presented with crown fracture with pulp involvement and 3.3 % presented with root fracture. In conclusion, the general prevalence of dentoalveolar trauma in patients attending the emergency clinic at the University of Alberta is less than other reported percentages in Canada or other countries.

scholarly journals Myocardial perfusion scintigraphy during the COVID-19 pandemic - findings from the university teaching hospital in Slovenia

2021 ◽  
Vol 22 (Supplement_3) ◽  
Author(s):  
B Guzic Salobir ◽  
M Dolenc Novak ◽  
M Stalc
Keyword(s):  
Nuclear Medicine ◽  
Myocardial Perfusion ◽  
Clinical Characteristics ◽  
Myocardial Perfusion Scintigraphy ◽  
Stress Tests ◽  
Pharmacological Stress ◽  
Perfusion Scintigraphy ◽  
Number Of Patients ◽  
The University ◽  
Second Wave

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Department for nuclear medicine in the University medical centre Ljubljana provides nuclear medicine diagnostic procedures for approximately 1.000.000 inhabitants of Slovenia. As many countries in Europe, Slovenia was faced with the first wave of the COVID-19 pandemic in early spring of 2020. Since our country is situated next to the northern part of Italy, where the situation was critical, our Ministry of health issued specific recommendations in March 2020. The aim was to increase hospital capacities for COVID-19 patients through limiting non-urgent diagnostic tests including myocardial perfusion scintigraphy (MPS) and to minimize the spread of the virus into hospital departments. The epidemiologic situation of the first wave resolved within 3 months. In the second wave of the pandemic in autumn 2020, the recommendations on patient care in non COVID-19 cases were less limiting to avoid worsening of non COVID-19 related diseases and patient prognosis. Purpose The aim of our study was to evaluate the influence of the COVID-19 pandemic on MPS in our medical institution. Methods Data on numbers of MPS, clinical characteristics of the patients and findings of MPS were prospectively collected for the first wave (in spring from March 15th to June 15th 2020) and second wave (in autumn from September 15th to December 15th 2020) of the pandemic and were compared with the same periods in 2019.  Results During the first wave we performed 40% less MPS, significantly more patients had pharmacological stress and were outpatients than in spring 2019. There were no significant differences in other clinical characteristics and MPS findings (Table 1 and Figure 1). In autumn 2020 we reorganized our schedule to increase the number of patients, which was once again comparable to previous year’s autumn. Although the number of patients was comparable, patients were now significantly older and had more often pharmacological stress, but there were no significant differences in other clinical data or MPS findings (Table 1 and Figure 1). Conclusions In our hospital, during the first wave of COVID-19 pandemic, we performed significantly less MPS than in the same period of the previous year. To minimize the possibility of virus transmission from asymptomatic patients, we followed international recommendations and avoided exercise stress tests but increased the percentage of pharmacological stress tests. A similar approach regarding the type of stress tests was chosen for the second wave in autumn of 2020. However, we decided to increase the number of MPS performed, in order to lessen the negative impact of the pandemic on non COVID-19 related diseases, focusing on coronary artery disease.

Sign in / Sign up

Export Citation Format

Share Document