Bengtsenbendtsen9519

ng Environment Review; GME Graduate Medical Education; IRB Institutional Review Board; PDSA Plan, Do, Study, Act.In a hospital setting, nurses and physicians are the two main caregivers for admitted patients. Their communication is an important driver of positive teamwork and ensures proper patient safety and a high level of patient care. In a hospital with a large internal medicine residency program, where the main communication between nurses and residents is by phone calls, the excess number of phone calls received, especially for non-urgent patient-related matters, can be disruptive and cause fatigue and burnout. Alternative means of communication have been reported, namely using the electronic medical records to try and create new means of communication and to decrease the burden of direct communication for non-urgent matters. #link# This manuscript describes the results of a survey administered in an attempt to understand the communication between residents and nurses in the setting of a new communication tool created within the electronic medical records.

Despite its proven utility, integration of point-of-care ultrasound (POCUS) into internal medicine (IM) residency training has been inconsistent. link2 Due to their unique constraints, community-based teaching hospitals may face particular challenges in providing POCUS training to IM residents.

To evaluate short-term educational outcomes of an academic center's POCUS curriculum following its adaptation and delivery to IM residents at a community-based teaching hospital.

A needs assessment (NA) regarding POCUS training was distributed to PGY-2 and PGY-3 IM residents at a community-based teaching hospital in 2017. Based on the NA results, a POCUS curriculum from an academic center was modified and a revised course was offered to the same residents. Participants completed cognitive assessments before and after three of the four didactic sessions. Observed placement of an ultrasound-guided peripheral IV before and after the training program comprised the skills assessment.

17 of 28 (61%) residents completed the NA; eleven participated in the course. Of 33 possible quiz pairs, 15 (45%) were completed. Average quiz scores rose after the first and third sessions. Skills assessment scores increased after course completion.

Adaptation of POCUS curricula from academic centers may be a feasible instructional strategy for community-based IM residency programs.

Adaptation of POCUS curricula from academic centers may be a feasible instructional strategy for community-based IM residency programs.We have completed volume 9 of the Journal of Community Hospital Internal Medicine Perspectives â€" JCHIMP. In this perspective piece we discuss the many achievements of our journal, including our impact factor, the diversity of institutions publishing, our editorial board, and the importance of our reviewers.The pandemic outbreak of COVID-19 challenges medical care systems all around the world. We here describe our experiences during the treatment of COVID-19 patients (n = 42) treated from 2 March 2020 to 16 April 2020 at a German district hospital. Forty-two COVID-19 patients were hospitalized and five patients developed a severe disease, requiring intensive care. Overall, 11 out of 42 hospitalized patients died. COVID-19 caused lymphocytopenia, as well as increased d-dimer, c-reactive protein and creatine kinase, and lactate dehydrogenase levels. These changes were mostly pronounced in patients that developed a severe disease course. Radiologic findings included ground-glass opacity, bilateral/multilobular involvement, consolidation, and posterior involvement. We compared COVID-19 patients to an average population of 'non-COVID' patients. Interestingly, no laboratory or radiologic finding was specific for COVID-19 when standing alone, as comorbidities of 'non-COVID' patients certainly can mimic similar results. link3 In common praxis, the diagnosis of COVID-19 is based on a positive PCR result. However, a false-negative result causes problems for the workflow of an entire hospital. In our clinic, the consequences of a false assumption of SARS-CoV-2 negativity in four cases had dramatic consequences, as contact persons had to be quarantined. To avoid this, a comprehensive view of lab-results, radiology, clinical symptoms and comorbidities is necessary for the correct diagnosis or exclusion of COVID-19.

The purpose of this study was to compare the potential effects of pedunculated and free synovial grafts in the repair of full-thickness articular cartilage defects on an animal model with histological and immunohistochemical analysis.

A comparative study in an animal model was performed with 24 rabbits, divided into two groups. Full-thickness cartilage defects were created bilaterally on the knees of all rabbits. Pedunculated and free synovial grafts were applied to the right knees of Group 1 and Group 2, respectively. Left knees were left as the control group. GS-5734 price from each group were randomly selected for euthanasia 4 and 8 weeks postoperatively. All samples were examined histologically with a cartilage scoring system. For immunohistochemical analysis, the degree of collagen 2 staining was determined using a staging system. All data were statistically compared between the study groups with Student's

-test or Mann-Whitney U-test. The correlations between categorical variables were analyzed withe the chondrogenic potential for the in vivo treatment of full-thickness cartilage defects.

Musculoskeletal tuberculosis (TB) continues to share the major burden of extrapulmonary TB. This burden up to some extent may be attributed to the implementation gap which is reasonably broadest at the level of the immediate point of care. As an orthopedic physician is an important stakeholder at this juncture, it is imperative to recognize their experiences, perceptions, and anticipations to fill this gap. This qualitative inquiry tries to explore these attributes in the context of the recent development at the policy level in Revised National Tuberculosis Control Program.

Qualitative inquiry with framework approach.

Orthopedic surgeons working in different work settings.

Purposive sampling. An iterative topic guide for an in-depth interview was prepared by reviewing the literature and expert opinions. The questions were contextual, diagnostic, evaluative, and strategic. This study adopted a framework approach as the issue was near to evaluative and strategic policy research. The recorded interviews were transcribed and coded into axial and serial codes. A framework matrix was created and thematic mapping was done to understand the phenomena and to offer the solution framework.

The investigators detected an element of unawareness of the current context coupled with the perceived previous stringency of the program. This is in conjunction with already multifaceted diagnostic and prognostic complexity. This leads to mutual dissociation and skepticism.

This qualitative inquiry explored an element of dissociation between programmatic objectives and individualistic concerns of the caregivers. An integrated ecosystem which may take care of synergistic reciprocation among the two is imperative for successful implementation.

This qualitative inquiry explored an element of dissociation between programmatic objectives and individualistic concerns of the caregivers. An integrated ecosystem which may take care of synergistic reciprocation among the two is imperative for successful implementation.

Tourniquet use is prevalent in the orthopaedic field to achieve a bloodless operating field, but it poses risks of local and systemic complications, including lung injury. This study aims to examine the effect of tourniquet application on the hindlimb of a rat to its lung.

This is an experimental study with 48 male Wistar strain rats as samples. The rats were divided into group A (

 = 24), killed directly after fracturization and tourniquet application, and group B (

 = 24), killed 14days post-procedure. Each group was divided into four group A1/B1 (control group, three hours tourniquet application without reperfusion interval), A2/B2 (5-min reperfusion between 2-h and 1-htourniquet application), A3/B3 (10-min reperfusion), and A4/B4 (15-min reperfusion). The lung tissue was examined histologically within ten high-power fields (400 × magnification). The severity of lung injury was measured using the Lung Injury Score (LIS). The oxidative damage was measured by determining the malondialdehyde (MDA) level, using the TBARS (thiobarbituric acid reactive substance assay) method.

There was a dose-dependent decrease of LIS and MDA in groups A and B with increasing reperfusion interval. Fifteen-minute reperfusion interval caused a 54.55% and 45.33% LIS reduction in groups A and B, respectively. All pair-wise group comparisons (

 < 0.05) showed significant differences. Five-minute interval reduced the MDA level by 16.56% and 30.13% in groups A and B, respectively. All possible pair-wise comparisons in both groups A and B also showed a significant difference (

 < 0.05).

Reperfusion interval is a possible clinical approach to mitigate the remote organ damage induced by limb ischemia-reperfusion injury.

Reperfusion interval is a possible clinical approach to mitigate the remote organ damage induced by limb ischemia-reperfusion injury.

The aim of the study was to evaluate the use of ultrasonography (USG) including power Doppler in detecting hand and wrist joint changes in early rheumatoid arthritis (RA) and to compare USG findings with magnetic resonance imaging (MRI).

Thirty-four patients diagnosed as RA by 2010 ACR/EULAR criteria; with the onset of symptoms within last one year, were included in the study after institute ethical clearance and informed consent to undergo USG and contrast-enhanced MRI of the dominant affected hand. Second to fifth metacarpophalangeal (MCP) joints, second to fifth proximal interphalangeal (PIP) joints and wrist joints (total nine joints) were evaluated for synovitis, erosions along with tenosynovitis. USG and MRI features were compared; agreement on the two imaging modalities as well as sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy of ultrasonography compared to MRI (gold standard) was calculated.

One hundred thirty-six MCP, 136 PIP a joint structure.

Pelvic inlet and outlet fluoroscopy views are routinely used in operative treatment of posterior pelvic ring injuries. In this study, we aimed to evaluate the angles of pelvic inlet and outlet fluoroscopic view, their differences with hip flexion and the correlation of these differences with sacral slope changes.

Sagittal reconstructions of 100 lumbopelvic CT were used to measure sacral slope, pelvic inlet and outlet view angles. The range of pelvic inlet-outlet view angles and their relation with age, sex and sacral slope were analyzed. In ten of these 100 patients, who were undergone a second CT imaging, hips were passively flexed to 60° to change pelvic tilt. The difference in sacral slope and pelvic inlet-outlet view angles in different positions were compared.

Mean angles for inlet view, outlet view and sacral slope were 28.9, 41.4 and 37.0, respectively. There was no difference between males and females (

 > 0.05). Pelvic outlet angles had a negative correlation with age (

 < 0.05). Sacral slope changes with hip flexion showed a negative correlation with inlet angles and positive correlation with outlet angles (

 < 0.