scholarly journals The Utilization of Physician Cell Phone Numbers by Patients in an Orthopaedic Surgery Practice

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0041
Author(s):  
Ryan G. Rogero ◽  
Daniel Corr ◽  
Meghan Bishop ◽  
Brandon Erickson ◽  
Daniel Seigerman ◽  
...  

Category: Other; Basic Sciences/Biologics Introduction/Purpose: There are a wide variety of ways in which physicians choose to manage communications with their patients outside of official visits and interactions. Some defer to ancillary staff/services (e.g. surgery schedulers, medical assistants) or mid-level providers (e.g. registered nurses, physicians assistants) until the situation warrants a call back directly from the physician. Less commonly, some choose to provide their cell phone number to patients to provide them with direct access should the need arise. The purpose of this prospective study was to explore to what extent patients utilize the cell phone numbers of orthopaedic surgeons in the immediate period after it is provided to them. Methods: Seven fellowship-trained orthopaedic surgeons from 5 different subspecialties (adult reconstruction, foot and ankle, hand and wrist, spine, sports) in a single private, multi-site orthopaedic surgery group located in a major metropolitan area each provided their personal cell phone number to approximately 30 consecutive patients during a 1-month period. The surgeon’s phone number was written down on a business card, and the surgeons themselves provided the card to the patient. Phone calls and voice mail messages received in the 30 days following the patient receiving the phone number were recorded, and the reasons for these calls were categorized as being ‘appropriate’ (e.g. acute postoperative issues, unclear instructions) or ‘inappropriate’ (e.g. administrative issues, medication refills, advanced imaging-related inquires). Logistic regression analysis was performed to determine if any patient variable or surgeon subspecialty was independently associated with calling the surgeon cell phone number. Results: Two-hundred seven patients, average age 51.5 years, were provided cell phone numbers. During the 30 days following administration of cell phone numbers, 21 patients (10.1%) made calls to their surgeon, for an average of 0.15 calls per patient. Six patients (2.9%) called more than once. Seventeen calls (54.8%) were deemed appropriate, and 14 calls (45.2%) inappropriate. Student’s t-tests (age) and chi-square analysis (sex, visit type, surgeon subspecialty) did not reveal significant difference between callers and non-callers (Table 2). Sports had the highest proportion of patients calling (16.9%), whereas foot & ankle had the lowest (4.0%), though surgeon subspecialty did not differ significantly (p=.3119). Logistic regression analysis did not reveal age (p=.7147), sex (p=.8230), visit type (p=.8745), or surgeon subspecialty (p=.1960) to be associated with calling. Conclusion: Our study has demonstrated a low rate of patient utilization of surgeon cell phone number when provided to them. If surgeons choose to provide their cell phone number to patients, we recommend specifying appropriate reasons to call in order to maximize the effectiveness of this communication method. [Table: see text]

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e15171-e15171
Author(s):  
Kiyofumi Shimoji ◽  
Takeshi Masuda ◽  
Yu Nakanishi ◽  
Kakuhiro Yamaguchi ◽  
Shinjiro Sakamoto ◽  
...  

e15171 Background: Immune check point inhibitor (ICI) induced interstitial lung disease (ICI-ILD) is a clinically serious and life-threatening toxicity. Pre-existing ILD has been reported to be a risk factor for ICI-ILD in patients with non-small cell lung cancer (NSCLC). In addition, we have previously reported that interstitial lung abnormality (ILA) is also a risk factor for the ICI-ILD. Therefore, we investigated whether any patient characteristics, including ILA, were risk factors for ICI-ILD in patients with non-NSCLC cancers. Methods: Head and neck cancer, malignant melanoma, oral cavity cancer, renal cell carcinoma or gastric cancer patients who received anti PD-1 antibody (Nivolumab or Pembrolizumab) at Hiroshima University Hospital from December 2015 to May 2019 were enrolled. Information on patient characteristics before anti-PD-1 antibody administration, including chest CT findings and laboratory data, were obtained. Results: Two hundred patients were enrolled, and 20 (10%) developed ICI-ILD. Grade1 was observed in 15 patients, grade2 in 3, and grade3 and 5 in 1. There was no significant difference in the background factors between patients with and without ICI-ILD. On the other hand, the proportion of patients with ILA was significantly higher in the patients with ICI-ILD than those without (P < 0.01). Furthermore, univariate logistic regression analysis revealed ILA was the risk factor for ICI-ILD (p < 0.01), and multivariate logistic regression analysis showed that GGA or reticulation in ILA was an independent risk factor for ICI-ILD (p = 0.016, 0.011). Conclusions: Pre-existing ILA is a risk factor for ICI-ILD, and GGA or reticulation in ILA is an independent risk factor for ICI-ILD in patients with non-NSCLC cancers. Therefore, we should pay more attention to the development of ICI-ILD in patients with ILA, especially GGA or reticulation.


2020 ◽  
Vol 20 (2) ◽  
pp. 467-471
Author(s):  
Kaio Raffael Valotta Bezerra ◽  
Sarah Cristina Sato Vaz Tanaka ◽  
Vanessa Resende Souza Silva ◽  
Marina Carvalho Paschoinni ◽  
Roseane Lopes da Silva Grecco ◽  
...  

Abstract Objectives: the present study aimed to evaluate the association between the rs1799998 polymorphism of the CYP11B2 gene and the susceptibility to preeclampsia (PE) in a Brazilian population. Methods: the study group comprised 61 women who were diagnosed with PE. The control group included 116 women who did not show changes in their blood pressure levels during their pregnancies. The rs1799998 polymorphism of the CYP11B2 gene was amplified by allele-specific polymerase chain reaction (PCR). A multiple logistic regression analysis was performed using the SNPStat program to evaluate the risk of the CYP11B2 gene rs1799998 polymorphism contributing to PE. Results: the PE group had the following genotypes: 1.64% CC, 91.80% CT, and 6.56% TT. In the control group, the observed genotypic frequencies were: 11% CC, 73% CT, and 16% TT. The genotypic frequency distribution did not fit the Hardy Weinberg Equilibrium (HWE) in either study group. The multiple logistic regression analysis showed a statistically significant difference for the rs1799998 polymorphism in the recessive model. Conclusion: the results suggest an association between the recessive model of C/C genotype of the rs1799998 polymorphism of the CYP11B2 gene and susceptibility to PE.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yu-Hsiang Su ◽  
Yu-Ming Chang ◽  
Chih-Ying Kung ◽  
Chiu-Kuei Sung ◽  
Wei-Shin Foo ◽  
...  

Abstract Background Aging reduces the quality and strength of bones and muscles and increases body fat, which can lead to the simultaneous occurrence of sarcopenia, osteopenia, and adiposity, a condition referred to as OsteoSarcopenic Adiposity (OSA). While previous studies have demonstrated that metabolic syndrome is associated with sarcopenia, osteopenia, and adiposity, the relationship between metabolic syndrome and OSA remains largely unknown. Methods We analyzed data for a sample of middle-aged individuals from a Health Management Center database, which was collected in 2016–2018. There are 2991 cases of people over 50 years from a physical examination center in a hospital in Taiwan during 2016–2018. In addition to descriptive statistics, chi-squared test, analysis of variance, and multinomial logistic regression analysis were conducted to examine OSA risk and associated factors. Results Based on multinomial logistic regression analysis, in different OSA severity level (1–3 more serious), those who are with metabolic syndrome has increased the 2.49–2.57 times risk of OSA (p < 0.001) in OSA = 2 and 3 groups while there is no significant difference in OSA =1 group. Conclusion The prevalence of OSA may impair the health and quality of life in the elderly group, especially those diagnosed with metabolic syndrome, increasing the risk of OSA. These results can help promote early diagnosis and treatment of OSA in clinical settings, particularly among aging individuals with abnormal physical function, the group with the highest OSA incidence.


2021 ◽  
Vol 93 (3) ◽  
pp. 280-284
Author(s):  
Ekrem Guner ◽  
Yavuz Onur Danacioglu ◽  
Yusuf Arikan ◽  
Kamil Gokhan Seker ◽  
Salih Polat ◽  
...  

Objective: This study aimed to determine the predictive effect of the presence of chronic prostatitis associated with prostate cancer (PCa) in prostate biopsy on Gleason score upgrade (GSU) in radical prostatectomy (RP) specimens. Materials and methods: The data of 295 patients who underwent open or robotic RP with a diagnosis of localized PCa following biopsy were retrospectively analyzed. Patients were divided into two groups with and without GSU following RP. Predictive factors affecting GSU on biopsy were determined. The impact of chronic prostatitis associated with prostate cancer on GSU was examined via logistic regression analysis. Results: Out of 224 patients with Gleason 3+3 scores on biopsy, 145 (64.7%) had Gleason upgrade, and 79 (35.2%) had no upgrade. Whilst comparing the two groups with and without Gleason upgrade in terms of patient age, prostate-specific antigen (PSA) value, PSA density (PSAD), prostate volume (PV), neutrophil/lymphocyte (N/L) ratio, number of positive cores, percentage of positive cores, and Prostate Imaging Reporting and Data System version 2 score, no statistically significant difference was detected. The presence of chronic prostatitis associated with PCa was higher in the patient cohort with GSU in contrast to the other group (p < 0.001). According to the univariate logistic regression analysis, the presence of chronic prostatitis was identified to be an independent marker for GSU. Conclusions: Pathologists and urologists should be careful regarding the possibility of a more aggressive tumor in the presence of chronic inflammation associated with PCa because inflammation within PCa was revealed to be linked with GSU after RP.


Author(s):  
Mayuka Oki ◽  
Miyuki Matsumoto ◽  
Yukiko Yoshikawa ◽  
Mitsuko Fukushima ◽  
Akira Nagasawa ◽  
...  

Aim: This study aimed to determine the main risk factors for falls in patients with Alzheimer disease (AD) by comparing balance, cognition, and visuospatial ability between those who have experienced a fall and those who have not. Methods: Forty-seven AD patients were admitted to a ward for patients with dementia (22 men and 25 women). The balance of patients was evaluated using the Functional Reach Test (FRT), the one-leg standing duration, and the Timed Up and Go (TUG) test. The Mini-Mental State Examination-Japanese (MMSE-J) was used to evaluate cognition. For visuospatial ability assessment, the Clock-Drawing Test (CDT) as well as overlapping figure identification and shape discrimination in the Visual Perception Test for Agnosia (VPTA) were used. The patients were allocated to either the fall group or the nonfall group based on their history of falls in the past year. The relationships between patients’ characteristics and evaluation outcomes were compared and examined. Logistic regression analysis was performed using a fall as the objective variable. The area under the curve (AUC) and the cutoff value were calculated. Results: Of the 47 participants, 22 had experienced falls within the past year (46.8%). The results of the FRT, one-leg standing duration, the TUG, the CDT, and the VPTA were significantly lower in the fall group. No significant difference between the MMSE-J scores of the fall group and those of the nonfall group was observed. The results of the logistic regression analysis indicated that falls in AD patients were significantly associated with the FRT. It was found that a shorter FRT distance (cm) had a significant impact on falls. For the FRT, the fall-related AUC was 0.755. At a cutoff value of 24.5 cm, the level of sensitivity was 68.0%, and the level of specificity was 77.3%. Conclusions: The findings of this study indicate that balance and visuospatial abilities are risks factors for falls in AD patients. In contrast, cognitive impairment was not a risk factor for falls. It was demonstrated that the FRT could be an appropriate risk predictor for falls in AD patients. In particular, falls in AD patients were strongly affected by a reduced dynamic balance.


2020 ◽  
Author(s):  
Xing Li ◽  
Huan Zhang ◽  
Zhuo Jia ◽  
Yunpeng Wang ◽  
Yong Song ◽  
...  

Abstract Background: The robot-assisted radical prostatectomy (RARP) has been widely applied in recent years; however, only a few studies are reported about long-term urinary continence after surgery. The present study aimed to examine the outcomes of continence rates (CRs) and determine the risk and protective factors of urinary continence in patients with prostate cancer (PCa) undergoing RARP. Methods: This retrospective study included 650 patients treated with RARP with perioperative data and at least one year of follow-up from January 2009 to November 2017. Also, the preoperative, intraoperative, and postoperative parameters of the patients were analyzed. Continence was defined as no pad use. Early and late continence was defined as the return of urinary continence within 3 months and beyond 12 months post-surgery, respectively. CRs were examined from 1–48 months postoperatively. Logistic regression analysis evaluated the association between the predictive factors and urinary continence in the early and late stages. Results: No significant difference was detected in the CR from 12–48 months postoperatively (P=0.766). Logistic regression analysis proved that pelvic lymph node dissection (PLND) was a significant risk factor of urinary continence at 1 month. Nerve-sparing (NS) was a significant protective factor of urinary continence at 1, 3, and 6 months. Advanced age was an independent risk factor of urinary continence at 6, 12, and 24 months. Other variables were not statistically significant predictors of urinary continence. Conclusions: The current results demonstrated that CR gradually improved with time within 1 year and stabilized 1 year after the surgery. PLND, NS, and age were significant determinants of continence in the early and late stages, respectively. These parameters could be used for preoperative identification of patients at high risk and counseling about postoperative expectations for urinary continence.


2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Raviraj Menon ◽  
Poornima Baby ◽  
Anil Kumar V. ◽  
Sandeep Surendran ◽  
Manu Pradeep ◽  
...  

Melioidosis is a tropical infectious disease with diverse clinical presentations. We aimed to investigate the characteristics and mortality risk factors of patients diagnosed with melioidosis in the past 10 years. This was a retrospective cohort study conducted at a quaternary care centre in South India. Clinical, demographic, and biochemical data in patients diagnosed with melioidosis with cultures were collected between January 2011 and December 2020 from medical records. Logistic regression analysis was performed to screen mortality risk factors of melioidosis in addition to descriptive statistics and chi-square analysis. Seventy-three melioidosis patients’ records were analysed, and the most common comorbidity was type 2 diabetes mellitus (n = 53, 72.6%). The patients showed diverse presentations: pulmonary involvement, 30 (41.1%); splenomegaly, 29 (39.7%); abscesses and cutaneous involvement, 18 (24.7%); lymph node, 10 (13.7%); arthritis and osteomyelitis, 9 (12.3%); and genitourinary infection, 4 (5.4%). The mortality was noted to be 15 (20.5%). Logistic regression analysis indicated that chronic kidney disease (OR = 14.0), CRP >100 IU/L (OR = 6.964), and S. albumin <3 gm/dl (OR = 8.0) were risk factors associated with mortality and can guide in risk stratification. Hypoalbuminemia is a novel mortality risk factor, detected in this study, and requires further investigation to validate its utility as a prognostic marker and reveal possible therapeutic benefits in clinical correction.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xiao Chen ◽  
Juan-juan Wang ◽  
Li Yu ◽  
Han-yu Wang ◽  
Hui Sun

Abstract Background There is no clear conclusion on the relationship between thyroid disease and obesity and lifestyle factors such as smoking and drinking. In this study, we analysed the association of body mass index (BMI), smoking and drinking with subclinical hypothyroidism (SHO) and thyroid nodules (TNs) with the results of a cross-sectional survey of urban residents in central China and discussed the potential mechanism linking these predictive factors and the two diseases. Methods This study included 1279 participants who were recruited from a Chinese community in 2011 and 2012. A questionnaire, laboratory examination and ultrasound diagnosis were conducted on these participants. Binary logistic regression analysis was used to analyse these factors. Results Overweight (BMI ≥ 25 kg/m2) was closely related to SHO and TNs in univariate and multivariate logistic regression analyses. Smoking had a protective effect on SHO and TNs, while drinking had a protective effect on TNs in univariate logistic regression and multivariate logistic regression with some covariates, but there was no significant difference between smoking and drinking and the two kinds of thyroid diseases in multivariate logistic regression analysis with all the covariates. In subgroup analysis, BMI ≥ 25 kg/m2 was significantly associated with SHO in people with positive thyroid antibodies (odds ratio (OR) = 2.221, 95 % confidence interval (CI): 1.168–4.184, P = 0.015) and smokers (OR = 2.179, 95 % CI: 1.041–4.561, P = 0.039). BMI ≥ 25 kg/m2 was significantly associated with TNs in people over 60 years old (OR = 2.069, 95 % CI: 1.149–3.724, P = 0.015) and drinkers (OR = 3.065, 95 % CI: 1.413–6.648, P = 0.005). Drinking alcohol had a protective effect on TNs in smokers (OR = 0.456, 95 % CI: 0.240–0.865, P = 0.016) and people with BMI ≥ 25 kg/m2 (OR = 0.467, 95 % CI: 0.236–0.925, P = 0.029). No significant association was found between smoking and the two thyroid diseases in different subgroups. Conclusions Obesity is a risk factor for both TNs and SHO, especially in elderly individuals and people with positive thyroid autoantibodies. Obesity and metabolic syndrome may be more associated with TNs than SHO. Smoking may have a protective effect on thyroid disease, while drinking may have a protective effect only on TNs.


2021 ◽  
Vol 11 ◽  
Author(s):  
Wei Li ◽  
Chao Xu ◽  
Zhaoxiang Ye

BackgroundPancreatic neuroendocrine tumors (PNETs) grade is very important for treatment strategy of PNETs. The present study aimed to find the quantitative radiomic features for predicting grades of PNETs in MR images.Materials and MethodsTotally 48 patients but 51 lesions with a pathological tumor grade were subdivided into low grade (G1) group and intermediate grade (G2) group. The ROI was manually segmented slice by slice in 3D-T1 weighted sequence with and without enhancement. Statistical differences of radiomic features between G1 and G2 groups were analyzed using the independent sample t-test. Logistic regression analysis was conducted to find better predictors in distinguishing G1 and G2 groups. Finally, receiver operating characteristic (ROC) was constructed to assess diagnostic performance of each model.ResultsNo significant difference between G1 and G2 groups (P &gt; 0.05) in non-enhanced 3D-T1 images was found. Significant differences in the arterial phase analysis between the G1 and the G2 groups appeared as follows: the maximum intensity feature (P = 0.021); the range feature (P = 0.039). Multiple logistic regression analysis based on univariable model showed the maximum intensity feature (P=0.023, OR = 0.621, 95% CI: 0.433–0.858) was an independent predictor of G1 compared with G2 group, and the area under the curve (AUC) was 0.695.ConclusionsThe maximum intensity feature of radiomic features in MR images can help to predict PNETs grade risk.


2015 ◽  
Vol 28 (2) ◽  
pp. 277-288
Author(s):  
Diego Marmorato Marino ◽  
Kamilla Tays Marrara ◽  
Juliano Ferreira Arcuri ◽  
Cecília Candolo ◽  
Mauricio Jamami ◽  
...  

Objective To analyze if there is influence of body weight, body mass index (BMI), body composition, dyspnoea, grip strength and tolerance to exertion in the occurrence of exacerbation during a 12-month follow up of patients with COPD who underwent a physical training program. Material and methods Sixty three patients were distributed in two groups, (Exacerbation Group — EG, n = 29; Non-Exacerbated Group — NEG, n = 34). The Mann Whitney test was used for the comparison between groups, the Friedman test (posthoc Dunn) to compare the assessments and the logistic regression analysis, with a significance level of p < 0.05. Results There is a significant difference between the groups in age and walked distance (WD) in the sixminute walk test (6MWT). The WD was reduced in 6th, 9th and 12th month revaluation compared to baseline and 3 months for the EG. Logistic regression analysis showed a significant interaction between the lean body mass and the WD, BMI with the lean body mass and the BMI with the WD, this and the isolated dyspnoea, and lean body mass with body weight. Conclusion Involving several variables along the follow up of patients with COPD in physical therapy programs is important, since it may prevent or reduce the chance of the occurrence of exacerbations. In addition, older patients with less tolerance to physical activity had a higher number of episodes of exacerbation, even when participating in a physiotherapy program associated to exercise training.


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