Prevalence of pulmonary disease in alcohol and poly substance abuse

AimsThe aim of this study is to identify the prevalence of pulmonary disease or progression of symptoms which can lead to respiratory disease in substance misuse. Identify risk: prescribe a safer substitute treatment (Methadone vs Buprenorphine). Identify combination of different drugs, causing toxicity and damage to lungs.BackgroundSmoking and illicit substance misuse is recognized as a cause of pulmonary diseaseMethodThe study was conducted in 2015 at outpatient addictions service (CAPS/CDC 69 Warwick Road London SW5 9HB). All 50-participants gave consent and data were collected including demographic details, history of substance abuse, route of administration, medical history, Peak Expiratory Flow rate (PEFR). A questionnaire was designed to assess the severity of shortness of breath (SOB), with or without exertion to ascertain the extent of the disease.Conclusion14 males and 3 females achieved 31 to 48.9 % of predicted PEFR. 13 males and 7 females achieved 51.1 to 69.6% of predicted PEFR. 7 males and 2 females achieved 70.8 to 91.1% of predicted PEFR. 2 males and 2 females achieved 100 to 114.3% of predicted PEFR. From the questionnaire on SOB with or without exertion, 8 males and 2 females reported moderate to severe shortness of breath on minimum exertion. 33 males and 11 females reported variable degree of SOB. 4 males and 2 females did not report SOB on reasonable exertion. 23 males and 10 females reported variable degree of SOB at rest, 14 males and 3 females reported no SOB at rest. 34 participants were receiving OST with methadone, 16 were on Buprenorphine. 6 patient treatments were switched to Buprenorphine due to Exacerbated COPD. 47 patients reported using Tobacco from harmful to dependent use. 44 patients reported harmful to dependent use of crack cocaine. 34 patients fulfilled the criteria of harmful use of cannabinoids. 33 patients were diagnosed with harmful to dependent use of alcohol. 10 patients reported heavy use of solvents. 2 patients reported harmful use of Party drugs. Many patients reported a history of recurrent chest infections 3-6 times a year, Asthma, COPD, Emphysema, Pneumonia and 2 were treated for Tuberculosis. 1/3 patients have a diagnosis of hypertension and IHD, liver disease and portal hypertension

Ophthalmology Residents' Experience with Complex Cataract Surgery at a VA Hospital over 10 Years

Objective The purpose of this study was to determine the proportion of complex cataract surgery performed by third-year ophthalmology residents at an academic Veterans Administration Medical Center. Methods A chart review was conducted of all resident cataract surgeries performed at the James J. Peters Veterans Administration Medical Center in The Bronx, NY between July 1, 2007, and June 30, 2017. Correct categorization was confirmed by review of operative report and reason for complex categorization was recorded, as well as the use and type of nonstandard device or technique. Results A total of 2,429 routine and 114 complex cataract surgeries were performed by 40 different residents over the 10-year period. In total, 4.5% of all cataract surgeries were categorized as complex. The most common reasons for complex categorization included intraoperative floppy iris syndrome (35.8%), miosis (38.4%), zonular instability (9.6%), mature cataract (7%), posterior synechiae (7.8%), and posterior capsular plaque (1.8%). Nonstandard techniques/devices included iris hooks (65.3%), pupil expansion device (8.5%), extracapsular cataract extraction (6.8%), synechiolysis (7.6%), mechanical iris dilation (0.8%), capsular tension ring (9.3%), and primary posterior continuous curvilinear capsulorhexis (1.7%). Conclusion A review of third-year resident cataract surgery experience at our institution's VA hospital where a significant amount of their surgical volume, approximately 50%, is obtained revealed that complex cataracts constituted a minimal portion of the cases. Education in cataract surgery should be competency based, extend beyond achieving minimums, and focus on variety and complexity of surgical experience. Formal tracking of routine versus complex cases should be considered to optimize training experience and assure patient safety.

PENGARUH PENGETAHUAN DAN MOTIVASI KERJA DOKTER SPESIALIS TERHADAP PENGISIAN REKAM MEDIS RAWAT INAP DI RUMAH SAKIT SANTA ELISABETH MEDAN

Medical Record is a collection of data and information on patients related to administration, medical clinical processes and medical support, quality management and outcome of those processes, which are documented and stored systematically and safely to be used by parties Entitled and concerned.. Aim: The purpose of this study was to analyze the influence of the knowledge and motivation of the specialist's work on the filling of the medical record in the hospital ward of Santa Elisabeth Hospital. Method: Type of research using explanatory research with associative approach. Population is all the specialist doctors who become Doctors in Patient Responsibility inpatient at Santa Elisabeth Hospital as many as 50 people, while the sample of research as many as 50 people. Data collection was done by giving questionnaires and observation sheet of medical record. Analysis of data with Chi Square and multiple logistic regression. Results: The results showed that: 1) The knowledge of specialist physicians influenced the filling of hospitalized medical records at Santa Elisabeth Hospital Medan. This is indicated by the value of p = 0.030, the value of exp (B) 6,837. 2) Working motivation of specialist doctors influential on filling in medical records inpatient Hospital Santa Elisabeth Medan. This is indicated by the value of p = 0.005, the value of exp (B) 6,635. 3). Conclusion: There is a positive and significant influence between the knowledge and motivation of the specialist's work on the filling of the hospitalization records of Santa Elisabeth Hospital in Medan..

Transitioning psychiatric patients for positive outcomes

A study was conducted at the Louis Stokes Cleveland Veterans Administration Medical Center (LSCVAMC) to examine if moving 20 psychiatric patients from one location to another affected their anxiety level. The LSCVAMC closed their Brecksville facility to consolidate the two Branches (Wade Park and Brecksville), and build a new Capital Asset Realignment for Enhanced Services (CARES) Tower. These changes were implemented to reduce operating costs for LSCVAMC and reduce the number of inpatient psychiatric beds. A five-question survey was given to each patient one week prior to the move, and immediately following the move to assess their thoughts related to the move. The results showed that despite 45% expressing thoughts that the move to Wade Park made them nervous/anxious prior to the move, no patients expressed that they were anxious post move when asked. Eighty percent of the patients expressed that they would enjoy being in a newly renovated facility. The post report of the patients was no nervousness/anxiety related to the move.

Corrigendum

Gary, R., Dunbar, S. B., Higgins, M., Butts, B., Corwin, E., Hepburn, K., … Miller, A. H. (2018). An Intervention to Improve Physical Function and Caregiver Perceptions in Family Caregivers of Persons With Heart Failure. Journal of Applied Gerontology. E pub ahead of print 19 January 2018. DOI: 10.1177/0733464817746757 In this article, the acknowledgment for the funder in the funding statement was missing. The correct funding statement is given below. The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work is supported in part by the National Institutes of Health National Institute of Nursing Research grant no. P01 1PO1NR011587 (PI-E. Corwin), Advancing Translational Sciences of the National Institutes of Health under award no. UL1TR000454 (D. Stephens), and the Atlanta Veterans Administration Medical Center. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or the Veterans Administration. This study is registered at www.clinicaltrials.gov (NCT01188070). The online version of this article has been corrected.