Objectives: Numerous national groups recognize that healthcare providers should be trained to care for patients with special healthcare needs who are transitioning from pediatric to adult health care, yet there is little emphasis on this training in most residency programs. The survey discussed here assessed resident preferences for a curriculum…
It is Friday night after midnight and the telephone rings. “Hello, I understand you are the admitting physician tonight. I am the admitting resident. I just evaluated a 19-year-old patient with cystic fibrosis with acute-on-chronic respiratory failure in the pediatric emergency department. He has pneumonia and continues to have a…
Objective: State health rankings present oversimplified and potentially damaging accounts of health status. Using the example of Kentucky, this article illustrates the realities masked by rankings that use averages and fail to account for social determinants of health. Methods: Findings from a range of publicly available data are combined to…
Objectives: Relatively little is known about the prevalence of and factors associated with the absence of fever, normal white blood cell count (WBC), lack of neutrophilia, and the frequency of elevated serum C-reactive protein (CRP) in adult hospitalized patients with bacteremia. Methods: Frequencies of fever (temperature ≥100°F), abnormal WBC count…
Anxiety and pain are common responses to surgery, and both can negatively affect patient outcomes. Music interventions have been suggested as a nonpharmacological intervention to alleviate pain and anxiety during surgical treatment. Although the data are somewhat mixed, the research suggests that music-based interventions are effective in reducing anxiety, pain…
To the Editor:The Choosing Wisely initiative was launched by the American Board of Internal Medicine in April 2012.1 The American College of Physicians was joined by eight other national medical societies, encouraging physicians to limit unnecessary testing in a time of spiraling healthcare costs.
Objectives: Undertriage is common in patients 55 years and older and is even worse for those 65 and older. In 1999, the Florida legislature implemented a statewide trauma system, including a new Florida trauma triage algorithm (FTTA). This study examines how the new system affected prehospital triage in younger versus…
Objectives: Bayesian interpretation of diagnostic test results usually involves point estimates of the pretest probability and the likelihood ratio corresponding to the test result; however, it may be more appropriate in clinical situations to consider instead a range of possible values to express uncertainty in the estimates of these parameters….
The current issue of the Southern Medical Journal features an article by Bianchi and colleagues that adds to our understanding of the clinical use of likelihood ratios (LRs).1 Likelihood ratios have been proposed as a tool allowing clinicians to use Bayes’ theorem at the bedside. Our purpose in this commentary…
The term renal osteodystrophy describes the pathological changes in bone structure in chronic kidney disease (CKD); however, this term fails to describe adequately the adverse changes in mineral and hormonal metabolism in CKD that have grave consequences for patient survival. CKD-mineral and bone disorder (CKD-MBD) is a broader, newly defined…
To the Editor:Patient satisfaction is an important marker of high-quality health care. Working to improve patient satisfaction has been linked to increased efficiency and efficacy in healthcare facilities.1 Among patients hospitalized for acute myocardial infarction, higher satisfaction scores were linked to lower inpatient mortality.2 An article addressing the challenges of…
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