Using Sonography to Examine Adult Patients at an Academic Medical Center: Have Usage Patterns Changed with the Expansion of Managed Care?

2002 ◽  
Vol 179 (6) ◽  
pp. 1395-1399 ◽  
Author(s):  
Marc E. Liebeskind ◽  
Peter H. Arger ◽  
Amy Liebeskind ◽  
Keith Maston ◽  
Curtis Langlotz
2015 ◽  
Vol 53 (2) ◽  
pp. 114-119 ◽  
Author(s):  
Sarah H. Ailey ◽  
Tricia J. Johnson ◽  
Louis Fogg ◽  
Tanya R. Friese

Abstract People with intellectual disabilities (ID) represent a small but important group of hospitalized patients who have higher rates of complications than do patients without ID hospitalized for the same reasons. Complications are potentially avoidable conditions, such as healthcare-acquired infections, healthcare-acquired skin breakdown, falls, and medication errors and reactions. Addressing factors related to complications can focus efforts to improve hospital care. The purpose of this exploratory study was to analyze data from reviews of academic medical center charts (N  =  70) about complications and to examine patient and hospitalization characteristics in relation to complications among adult patients (age ≥ 18 years) with ID hospitalized for nonpsychiatric reasons. Adults with ID tended to be twice as likely to have complications (χ2  =  2.893, df  =  1, p  =  .09) if they had a surgical procedure and were nearly four times as likely to have complications (χ2  =  6.836, df  =  1, p  =  .009) if they had multiple chronic health conditions (three of the following: history of cerebral palsy, autism spectrum symptoms, aggressive behavior, respiratory disorder, and admission through the emergency department). Findings suggest preliminary criteria for assessing risk for complications among hospitalized people with ID and the need for attention to their specific needs when hospitalized.


2021 ◽  
pp. 112972982110548
Author(s):  
Jonathan D Cura

Background: Along with the challenges to strengthen patient safety in the use of short peripheral catheters (SPCs), various studies have been conducted in the past to explore differences between two main types of SPCs—integrated SPC (ISPC) and simple SPC (SSPC) in terms of clinical performance. The accumulated evidence from the literature lean toward the benefits of ISPC use in preventing complications leading to longer dwell time and more economical savings than SSPC use. The study aimed to compare ISPC and SSPC in terms of first-attempt successful insertions, number of attempts before successful insertion, perceived ease of insertion, dwell time, reinsertion rate, reasons for removal, and costs of supplies used for the insertions. Furthermore, it aimed to verify whether the previous results of referenced work in the use of ISPC were similar, and its use provided more foreseeable benefit for patient safety and cost-efficiency. Methods: This quasi-experimental study was conducted in a 650-bed tertiary academic medical center in the Philippines. Eligible participants were adult patients who were required SPC for at least 72 h by the physician. Using inferential statistics, comparisons were done among adult patients with integrated ( n = 350) and simple ( n = 350) SPC. Comparisons were also made according to insertion site and gauge of SPC. Results: The successful first-attempt insertions did not vary significantly at around 80% in both groups ( p = 0.428). No significant differences were found in terms of attempts before successful insertion ( p = 0.677), dwell time ( p = 0.144), reinsertions ( p = 0.934), and reasons for removal ( p = 0.424). Meanwhile, comparable differences were noted in terms of perceived ease of insertion ( p < 0.001) and cost of supplies used during the insertions ( p < 0.001). Conclusion: ISPCs can yield the same results with that of SSPCs while being easier to use and less costly.


2011 ◽  
Vol 38 (6Part5) ◽  
pp. 3413-3413
Author(s):  
M Naveed ◽  
W Huda ◽  
S Tipnis ◽  
E Mah ◽  
G Frey

2016 ◽  
Vol 30 (2) ◽  
pp. 209-213 ◽  
Author(s):  
Vincent Peyko ◽  
Samantha Smalley ◽  
Henry Cohen

Purpose: To prospectively evaluate the observed incidence of acute kidney injury (AKI) in adult patients receiving the combination of piperacillin-tazobactam and vancomycin versus the combination of cefepime or meropenem and vancomycin for greater than 72 hours. Methods: This was a prospective, open-label cohort study at a community academic medical center involving adult patients over a 3-month time period who received either the combination of piperacillin-tazobactam and vancomycin or the combination of cefepime or meropenem and vancomycin for greater than 72 hours. The patients were evaluated for AKI, defined using specific criteria introduced by Kidney Disease: Improving global outcomes (KDIGO) acute kidney injury work group in 2012. Results: A total of 85 patients receiving either antimicrobial combination were evaluated for AKI. The incidence of AKI was significantly higher in the piperacillin-tazobactam and vancomycin group (37.3%) compared with the cefepime or meropenem and vancomycin group (7.7%; χ2 = 7.80, P = .005). Conclusion: The result of this study suggests that the risk of developing AKI is increased in patients receiving the combination of piperacillin-tazobactam and vancomycin versus those receiving the combination of cefepime or meropenem and vancomycin.


Author(s):  
Wanting Cui ◽  
Joseph Finkelstein

The COVID-19 pandemic changed the landscape of telehealth services. The goal of this paper was to identify demographic groups of patients who have used telemedicine services before and after the start of the pandemic, and to analyze how different demographic groups’ telehealth usage patterns change throughout the course of the pandemic. A de-identified study dataset was generated by querying electronic health records at the Mount Sinai Health System to identify all patients. 129,625 patients were analyzed. Demographic shifts in patients seeking telemedicine service were identified. There was significant increase in the middle age and older population using telehealth services. During the pandemic use of telemedicine services was increased among male patients and racial minority patients. Furthermore, telehealth services had expanded to a broader spectrum of medical specialties.


Neurology ◽  
2020 ◽  
Vol 96 (1) ◽  
pp. e102-e110
Author(s):  
Urs Fisch ◽  
Sira M. Baumann ◽  
Saskia Semmlack ◽  
Stephan Marsch ◽  
Stephan Rüegg ◽  
...  

ObjectiveTo test the accuracy of an equation in adult patients with status epilepticus that calculates the free concentration of serum valproic acid (fVPA) from the total concentration of serum valproic acid (tVPA) and serum albumin.MethodsAll adult patients with status epilepticus who were treated at a Swiss academic medical center between 2005 and 2018 with concurrent measurements of tVPA, fVPA, and serum albumin were included. fVPA was categorized as subtherapeutic, therapeutic (5–10 mg/L), or supratherapeutic. Agreement was defined as the proportion of measured and calculated fVPA falling within the same category.ResultsOf 676 patients with status epilepticus, 104 had 506 measurements, with a median of 3 (interquartile range [IQR] 1.5–6.5) per patient. The median tVPA was 43.5 mg/L (27.4–63.6), with measured fVPA 9.1 mg/L (4.5–14.7) and calculated fVPA 10.1 mg/L (7.0–13.0), respectively. The median deviation of calculated from measured fVPA was −0.8 mg/L (−3.2 to 2.5) with 336 measurements >1 mg/L. While the association between measured and calculated fVPA was linear (regression coefficient 1.1, 95% confidence interval 0.9–1.2, p < 0.0001), the agreement on effective drug levels did not match in 39.8% of measurements regardless of serum albumin levels, with calculated fVPA overestimating measured fVPA in 30.4%. tVPA and serum albumin independently influenced the accuracy of the calculated fVPA in the multivariable model.ConclusionsCalculated fVPA is inaccurate when using the proposed equation in adult patients with status epilepticus, calling for drug monitoring based on measured fVPA in this context.


2018 ◽  
Vol 23 ◽  
pp. 117-121 ◽  
Author(s):  
David Sugrue ◽  
Andrew S. Jarrell ◽  
Rachel Kruer ◽  
Stephanie Davis ◽  
Dachelle Johnson ◽  
...  

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