scholarly journals Mentoring the next generation of physician-scientists in Japan: a cross-sectional survey of mentees in six academic medical centers

2015 ◽  
Vol 15 (1) ◽  
Author(s):  
Ken Sakushima ◽  
Hiroki Mishina ◽  
Shunichi Fukuhara ◽  
Kenei Sada ◽  
Junji Koizumi ◽  
...  
Keyword(s):  
Academic Medical Centers ◽  
Next Generation ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Medical Centers ◽  
Academic Medical ◽  
Physician Scientists

scholarly journals Hospitalists as Triagists: Description of the Triagist Role across Academic Medical Centers

2019 ◽  
pp. 87-90
Author(s):  
Sadie Trammel Velasquez ◽  
Emily S Wang ◽  
Andrew A White ◽  
Jagriti Chadha ◽  
Michael Mader ◽  
...  
Keyword(s):  
Electronic Communication ◽  
Academic Medical Centers ◽  
Inpatient Service ◽  
Advanced Practice ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Medical Centers ◽  
Academic Medical ◽  
Communication Practices ◽  
Similarities And Differences

From the hospitalist perspective, triaging involves the evaluation of a patient for potential admission to an inpatient service. Although traditionally done by residents, many academic hospitalist groups have assumed the responsibility for triaging. We conducted a cross-sectional survey of 235 adult hospitalists at 10 academic medical centers (AMCs) to describe the similarities and differences in the triagist role and assess the activities and skills associated with the role. Eight AMCs have a defined triagist role; at the others, hospitalists supervise residents/advanced practice providers. The triagist role is generally filled by a faculty physician and shared by all hospitalists. We found significant variability in verbal communication practices (P = .02) and electronic communication practices (P < .0001) between the triagist and the current provider (eg, emergency department, clinic provider), and in the percentage of patients evaluated in person (P < .0001). Communication skills, personal efficiency, and systems knowledge are dominant themes of attributes of an effective triagist.

scholarly journals Pattern of Frequent But Nontargeted Pharmacologic Thromboprophylaxis for Hospitalized Patients With Cancer at Academic Medical Centers: A Prospective, Cross-Sectional, Multicenter Study

2014 ◽  
Vol 32 (17) ◽  
pp. 1792-1796 ◽  
Author(s):  
Jeffrey I. Zwicker ◽  
Adam Rojan ◽  
Federico Campigotto ◽  
Nadia Rehman ◽  
Renee Funches ◽  
...  
Keyword(s):  
High Risk ◽  
Scoring System ◽  
Hospitalized Patients ◽  
Academic Medical Centers ◽  
Cross Sectional ◽  
Patients With Cancer ◽  
Medical Centers ◽  
Academic Medical ◽  
Pharmacologic Thromboprophylaxis ◽  
To Receive

Purpose Hospitalized patients with cancer are considered to be at high risk for venous thromboembolism (VTE). Despite strong recommendations in numerous clinical practice guidelines, retrospective studies have shown that pharmacologic thromboprophylaxis is underutilized in hospitalized patients with cancer. Patients and Methods We conducted a prospective, cross-sectional study of hospitalized patients with cancer at five academic hospitals to determine prescription rates of thromboprophylaxis and factors influencing its use during hospitalization. Results A total of 775 patients with cancer were enrolled across five academic medical centers. Two hundred forty-seven patients (31.9%) had relative contraindications to pharmacologic prophylaxis. Accounting for contraindications to anticoagulation, the overall rate of pharmacologic thromboprophylaxis was 74.2% (95% CI, 70.4% to 78.0%; 392 of 528 patients). Among the patients with cancer without contraindications for anticoagulation, individuals hospitalized with nonhematologic malignancies were significantly more likely to receive pharmacologic thromboprophylaxis than those with hematologic malignancies (odds ratio [OR], 2.34; 95% CI, 1.43 to 3.82; P = .007). Patients with cancer admitted for cancer therapy were significantly less likely to receive pharmacologic thromboprophylaxis than those admitted for other reasons (OR, 0.37; 95% CI, 0.22 to 0.61; P < .001). Sixty-three percent of patients with cancer classified as low risk, as determined by the Padua Scoring System, received anticoagulant thromboprophylaxis. Among the 136 patients who did not receive anticoagulation, 58.8% were considered to be high risk by the Padua Scoring System. Conclusion We conclude that pharmacologic thromboprophylaxis is frequently administered to hospitalized patients with cancer but that nearly one third of patients are considered to have relative contraindications for prophylactic anticoagulation. Pharmacologic thromboprophylaxis in hospitalized patients with cancer is commonly prescribed without regard to the presence or absence of concomitant risk factors for VTE.

scholarly journals The Importance of the Autopsy in Medicine: Perspectives of Pathology Colleagues

2019 ◽  
Vol 6 ◽  
pp. 237428951983404 ◽  
Author(s):  
Louis Maximilian Buja ◽  
Rolf F. Barth ◽  
Gerhard R. Krueger ◽  
Sergey V. Brodsky ◽  
Robert L. Hunter
Keyword(s):  
Viral Infections ◽  
Academic Medical Centers ◽  
Positive Side ◽  
Medical Centers ◽  
Academic Medical ◽  
Formalin Fixed Paraffin ◽  
Formalin Fixed Paraffin Embedded ◽  
Artery Disease ◽  
Physician Scientists ◽  
Formalin Fixed

This article presents a perspective on the importance of the autopsy in medical practice and science based on experiences of the authors as physician-scientists involved in autopsy practice. Our perspectives are presented on the seminal contributions of the autopsy in the areas of cardiovascular disease, including congenital heart disease, atherosclerosis, coronary artery disease, and myocardial infarction, and infectious disease, including tuberculosis and viral infections. On the positive side of the future of the autopsy, we discuss the tremendous opportunities for important research to be done by application of advanced molecular biological techniques to formalin-fixed, paraffin-embedded tissue blocks obtained at autopsy. We also note with concern the countervailing forces impacting the influence of pathology in education and clinical practice at our academic medical centers, which also present impediments to increasing autopsy rates. Our challenge as academic pathologists, whose careers have been molded by involvement in the autopsy, is to counter these trends. The challenges are great but the benefits for medicine and society are enormous.

scholarly journals Publication and reporting of clinical trial results: cross sectional analysis across academic medical centers

BMJ ◽  
2016 ◽  
pp. i637 ◽  
Author(s):  
Ruijun Chen ◽  
Nihar R Desai ◽  
Joseph S Ross ◽  
Weiwei Zhang ◽  
Katherine H Chau ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Academic Medical Centers ◽  
Cross Sectional ◽  
Cross Sectional Analysis ◽  
Medical Centers ◽  
Academic Medical ◽  
Clinical Trial Results ◽  
Sectional Analysis

scholarly journals Hospital Ward Adaptation During the COVID-19 Pandemic: A National Survey of Academic Medical Centers

2020 ◽  
Vol 15 (8) ◽  
pp. 483-488 ◽  
Author(s):  
Andrew Auerbach ◽  
Kevin J O'Leary ◽  
S Ryan Greysen ◽  
James D Harrison ◽  
Sunil Kripalani ◽  
...  
Keyword(s):  
Hospital Medicine ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Medical Centers ◽  
Use Of Technology ◽  
Academic Medical ◽  
Critical Approaches ◽  
Medical Wards ◽  
Or Team ◽  
Team Types

IMPORTANCE: Although intensive care unit (ICU) adaptations to the coronavirus disease of 2019 (COVID-19) pandemic have received substantial attention , most patients hospitalized with COVID-19 have been in general medical units. OBJECTIVE: To characterize inpatient adaptations to care for non-ICU COVID-19 patients. DESIGN: Cross-sectional survey. SETTING: A network of 72 hospital medicine groups at US academic centers. MAIN OUTCOME MEASURES: COVID-19 testing, approaches to personal protective equipment (PPE), and features of respiratory isolation units (RIUs). RESULTS: Fifty-one of 72 sites responded (71%) between April 3 and April 5, 2020. At the time of our survey, only 15 (30%) reported COVID-19 test results being available in less than 6 hours. Half of sites with PPE data available reported PPE stockpiles of 2 weeks or less. Nearly all sites (90%) reported implementation of RIUs. RIUs primarily utilized attending physicians, with few incorporating residents and none incorporating students. Isolation and room-entry policies focused on grouping care activities and utilizing technology (such as video visits) to communicate with and evaluate patients. The vast majority of sites reported decreases in frequency of in-room encounters across provider or team types. Forty-six percent of respondents reported initially unrecognized non–COVID-19 diagnoses in patients admitted for COVID-19 evaluation; a similar number reported delayed identification of COVID-19 in patients admitted for other reasons. CONCLUSION: The COVID-19 pandemic has required medical wards to rapidly adapt with expanding use of RIUs and use of technology emerging as critical approaches. Reports of unrecognized or delayed diagnoses highlight how such adaptations may produce potential adverse effects on care. Journal of Hospital Medicine 2020;15:XXXXXX. © 2020 Society of Hospital Medicine

Unplanned Reoperation and Implant Revision After Total Wrist Arthroplasty

Hand ◽  
2020 ◽  
pp. 155894471989881 ◽  
Author(s):  
Taylor M. Pong ◽  
Wouter F. van Leeuwen ◽  
Kamil Oflazoglu ◽  
Philip E. Blazar ◽  
Neal Chen
Keyword(s):  
Risk Factors ◽  
Implant Removal ◽  
Academic Medical Centers ◽  
Implant Design ◽  
Factors Associated ◽  
Medical Centers ◽  
Total Wrist Arthroplasty ◽  
Academic Medical ◽  
Related Risk ◽  
Wrist Arthroplasty

Background: Total wrist arthroplasty (TWA) is a treatment option for many debilitating wrist conditions. With recent improvements in implant design, indications for TWA have broadened. However, despite these improvements, there are still complications associated with TWA, such as unplanned reoperation and eventual implant removal. The goal of this study was to identify risk factors for an unplanned reoperation or implant revision after a TWA at 2 academic medical centers between 2002 and 2015. Methods: In this retrospective study, 24 consecutive TWAs were identified using CPT codes. Medical records were manually reviewed to identify demographic, patient- or disease-related, and surgery-related risk factors for reoperation and implant removal after a primary TWA. Results: Forty-six percent of wrists (11 of 24 TWAs performed) had a reoperation after a median of 3.4 years, while 29% (7 of 24) underwent implant revision after a median of 5 years. Two patients had wrist surgery prior to their TWA, both eventually had their implant removed ( P = .08). There were no risk factors associated with reoperation or implant removal. Conclusion: Unplanned reoperation and implant removal after a primary TWA are common. Approximately 1 in 3 wrists are likely to undergo revision surgery. We found no factors associated with reoperation or implant removal; however, prior wrist surgery showed a trend toward risk of implant removal after TWA.

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