To see the other types of publications on this topic, follow the link: Department of Chief Medical Examiner.
Journal articles on the topic 'Department of Chief Medical Examiner'
Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles
Consult the top 50 journal articles for your research on the topic 'Department of Chief Medical Examiner.'
Next to every source in the list of references, there is an 'Add to bibliography' button. Press on it, and we will generate automatically the bibliographic reference to the chosen work in the citation style you need: APA, MLA, Harvard, Chicago, Vancouver, etc.
You can also download the full text of the academic publication as pdf and read online its abstract whenever available in the metadata.
Browse journal articles on a wide variety of disciplines and organise your bibliography correctly.
1
Dadeh, Ar-aishah, and Pitshaya Phunyanantakorn. "Factors Affecting Length of Stay in the Emergency Department in Patients Who Presented with Abdominal Pain." Emergency Medicine International 2020 (May 27, 2020): 1–7. http://dx.doi.org/10.1155/2020/5406516.
Full textAbstract:
Objective. We aimed to identify factors affecting length of stay in the emergency department in patients who presented with abdominal pain. Methods. A retrospective cohort study was conducted from 1 January 2017 to 31 December 2017. The medical records were reviewed from 217 patients older than 15 years with the chief complaint of abdominal pain. The patients were divided into emergency department length of stay (EDLOS) < 4 hours and ≥4 hours. The two groups were compared in terms of baseline characteristics, physical examination, time of presenting, attending physicians, interdepartmental consultations, investigations, ED disposition, final diagnosis, and mortality. The significant factors affecting longer EDLOS were examined using univariate and multivariate analyses by logistic regression. Results. Factors affecting longer EDLOS were age ≥50 (odds ratio (OR) 3.17, 95% confidence interval (CI) 1.36–7.42), interdepartmental consultation ≥2 specialists (OR 71.82, 95% CI 5.67–909.51), blood testing ≥2 rounds (OR 85.6, 95% CI 4.22–1734.6), and ultrasonography (OR 8.28, 95% CI 1.84–37.26). Conclusion. The study found that the statistically significant factors that prolonged EDLOS in patients with the chief complaint of abdominal pain were age, rounds of blood test, interdepartmental consultation, and the need for ultrasonography.
2
Il'kova, Olga Petrovna, Yelena Ivanovna Ustinova, and Nikolay Nikolayevich Sal'nikov. "An improvement of medical care for children and adolescents with ocular tuberculosis in Saint-Petersburg - an important goal of city dispensary." Ophthalmology journal 7, no. 4 (December 15, 2014): 79–83. http://dx.doi.org/10.17816/ov2014479-83.
Full textAbstract:
The medical care for children with ocular tuberculosis until the end of the nineties was delivered in the Saint-Petersburg City Diagnostic Centre # 7, OLS. Under dispensary observation in the tuberculosis department, there were no less than 100 patients with hematogenous tuberculosis (in association with tuberculosis contamination or local forms of non-ocular localizations). Recently, there has been only a half time ophthalmologist in the dispensary to admit children and adolescents with ocular tuberculosis or suspected cases. Upon an initiative of phthisioophthalmology section of the Saint-Petersburg scientific medical ophthalmological society to the staff of the city dispensary ophthalmologist O.P. Il’kova was recommended and admitted, with a specialization to work as pediatric phthisioophthalmologist. During 2014, O.P. Il’kova attended to adult patients at the ophthalmology department of the dispensary, consulted adolescents in the “Drujba” tuberculosis sanatorium and analysed the treatment results of tuberculosis patients who became ill at their childhood. The phthisioophthalmology section of the Saint-Petersburg scientific medical ophthalmological society and the ophthalmology department of the Saint-Petersburg anti-tuberculosis dispensary solicit the chief executives of the dispensary to allocate ophthalmologist, nurse positions and to create necessary conditions to examine and treat children and adolescents with ocular tuberculosis or suspected cases.
3
Khan, Nashid Tabassum, Palash Kumar Bose, Syed Tanjilul Haque, Sohel Mahmud, and Rezina Sultana. "Suicidal Death due to Organophosphorus Compound Poisoning ? an Experience of 67 Cases." Journal of Enam Medical College 6, no. 2 (June 21, 2016): 97–100. http://dx.doi.org/10.3329/jemc.v6i2.27765.
Full textAbstract:
Background: Bangladesh is an agro-based country. Suicide by agrochemical compounds are increasing day by day in this country. Organophosphorus compounds (OPC) are commonly used for suicide. Mostly these are used for suicidal purpose in rural areas in our country due to low cost, toxicity and availability.Objective: To find out the relationship of age and sex variation along with the causes that influenced different income group people to ingest OPC for committing suicide.Materials and Methods: This study was conducted in the Department of Forensic Medicine, Dhaka Medical College during January to December 2010. Data were collected at the time of autopsy and from postmortem examination report of viscera. Viscera were preserved and sent to the Chief Chemical Examiners Office, Dhaka for toxicological analysis.Results: In this study, middle aged subjects (2030 years) were found to commit suicide using OPC in comparison to other age groups. Among the cases male were 57% and female 43%. Poverty was found as the most common cause (20%) of OPC poisoning.Conclusion: Poverty is the leading cause of death of OPC poisoning followed by failure in love and adultery. Business failure, unhappiness in conjugal life, demand for dowry and violence against women are other causes to commit suicide by OPC.J Enam Med Col 2016; 6(2): 97-100
4
Clawson, Jeff, Greg Scott, Weston Lloyd, Brett Patterson, Tracey Barron, Isabel Gardett, and Christopher Olola. "Outcome Accuracy of the Emergency Medical Dispatcher's Initial Selection of a Diabetic Problems Protocol." Prehospital and Disaster Medicine 29, no. 1 (December 10, 2013): 37–42. http://dx.doi.org/10.1017/s1049023x13008923.
Full textAbstract:
AbstractIntroductionDiabetes mellitus, although a chronic disease, also can cause acute, sudden symptoms requiring emergency intervention. In these cases, Emergency Medical Dispatchers (EMDs) must identify true diabetic complaints in order to determine the correct care. In 911 systems utilizing the Medical Priority Dispatch System (MPDS), International Academies of Emergency Dispatch-certified EMDs determine a patient's chief complaint by matching the caller's response to an initial pre-scripted question to one of 37 possible chief complaints protocols. The ability of EMDs to identify true diabetic-triggered events reported through 911 has not been studied.ObjectiveThe primary objective of this study was to determine the percentage of EMD-recorded patient cases (using the Diabetic Problems protocol in the MPDS) that were confirmed by either attending paramedics or the hospital as experiencing a diabetic-triggered event.MethodsThis was a retrospective study involving six hospitals, one fire department, and one ambulance service in Salt Lake City, Utah USA. Dispatch data for one year recorded under the Diabetic Problems protocol, along with the associated paramedic and hospital outcome data, were reviewed/analyzed. The outcome measures were: the percentage of cases that had diabetic history, percentage of EMD-identified diabetic problems cases that were confirmed by Emergency Medical Services (EMS) and/or hospital records as true diabetic-triggered events, and percentage of EMD-identified diabetic patients who also had other medical conditions. A diabetic-triggered event was defined as one in which the patient's emergency was directly caused by diabetes or its medical management. Descriptive statistics were used for categorical measures and parametric statistical methods assessed the differences between study groups, for continuous measures.ResultsThree-hundred ninety-three patient cases were assigned to the Diabetic Problems Chief Complaint protocol. Of the 367 (93.4%) patients who had a documented history of diabetes, 279 (76%) were determined to have had a diabetic-triggered event. However, only 12 (3.6%) initially assigned to this protocol did not have a confirmed history of diabetes.ConclusionsUsing the MPDS to select the Diabetic Problems Chief Complaint protocol, the EMDs correctly identified a true diabetic-triggered event the majority of the time. However, many patients had other medical conditions, which complicated the initial classification of true diabetic-triggered events. Future studies should examine the associations between the five specific Diabetic Problems Chief Complaint protocol determinant codes (triage priority levels) and severity measures, eg, blood sugar level and Glasgow Coma Score.ClawsonJ, ScottG, LloydW, PattersonB, BarronT, GardettI, OlolaC. Outcome accuracy of the Emergency Medical Dispatcher's initial selection of a Diabetic Problems Protocol. Prehosp Disaster Med. 2013:28(6):1-6.
5
Cook, Sharlette, Khin Lay Maw, Sonal S. Munsiff, Paula I. Fujiwara, and Thomas R. Frieden. "Prevalence of Tuberculin Skin Test Positivity and Conversions Among Healthcare Workers in New York City During 1994 to 2001." Infection Control & Hospital Epidemiology 24, no. 11 (November 2003): 807–13. http://dx.doi.org/10.1086/502141.
Full textAbstract:
AbstractObjective:To determine the prevalence of and risk factors for tuberculin skin test positivity and conversion among New York City Department of Health and Mental Hygiene employees.Design:Point-prevalence survey and prospective cohort analysis. Sentinel surveillance was conducted from March 1,1994, to December 31, 2001.Participants:HCWs in high-risk and low-risk settings for occupational TB exposure.Results:Baseline tuberculin positivity was 36.2% (600 of 1,658), 15.5% (143 of 922) among HCWs born in the United States, and 48.5% (182 of 375) among HCWs not born in the United States. There were 36 tuberculin conversions during 2,754 observation-years (rate, 1.3 per 100 person-years). For HCWs born in the United States, the risk for tuberculin conversion was greater in high-risk occupational settings compared with low-risk settings (OR 5.7; CI95, 1.7–19.2;P< .01). HCWs not born in the United States and those employed at the Office of the Chief Medical Examiner (OCME) were at high risk for baseline tuberculin positivity (OR, 3.2; CI95,1.7–5.8;P< .001); OCME HCWs (OR 4.7; CI95, 2.3–9.4;P< .001), those of Asian ethnicity (OR 4.3; CI95,1.4–13.5;P< .01), and older HCWs (OR, 1.0; CI95,1.0–1.1;p< .05) were at a higher risk for conversion.Conclusions:Although the prevalence of tuberculin positivity decreased after the peak of the recent TB epidemic in New York City, the conversion rate among HCWs in high-risk occupational settings for TB exposure was still greater than that among HCWs in low-risk settings. Continued surveillance of occupational TB infection is needed, especially among high-risk HCWs.
6
Rudolf, Frances, Kathryn Hollenbach, Keri L. Carstairs, and Shaun D. Carstairs. "A Retrospective Review of Antipsychotic Medications Administered to Psychiatric Patients in a Tertiary Care Pediatric Emergency Department." Journal of Pediatric Pharmacology and Therapeutics 24, no. 3 (May 1, 2019): 234–37. http://dx.doi.org/10.5863/1551-6776-24.3.234.
Full textAbstract:
OBJECTIVES An increasing number of pediatric patients with psychiatric chief complaints present to emergency departments (EDs) nationwide. Many of these patients require treatment with antipsychotic medications to treat agitation. We sought to examine the use of antipsychotic medications in pediatric patients presenting to a tertiary care pediatric ED. METHODS We performed a retrospective electronic medical record review of patients presenting to a tertiary care pediatric hospital from January 2009 through February 2016 with a psychiatric chief complaint who received an antipsychotic medication in the ED. RESULTS A total of 229 patients were identified, 54.1% of whom were male. Mean age was 14.4 ± 2.6 years. Commonly administered medications included olanzapine (51.1%), aripiprazole (26.6%), haloperidol (24.0%), and risperidone (11.8%). Eighty-seven patients (38.0%) were given at least 1 intravenous or intramuscular dose of antipsychotic medication. A total of 113 patients (49.3%) received only 1 antipsychotic medication, 65 (28.4%) received 2, 30 (13.1%) received 3, and 21 (9.2%) received 4 or more antipsychotics. Median length of stay (minutes) increased significantly with increasing number of medications administered (p < 0.001). Length of stay was significantly shorter in patients given only oral medications (675.6 minutes, IQR 418–1194) compared to those given at least one intramuscular or intravenous dose (951 minutes, IQR 454–1652) (p = 0.014). CONCLUSIONS In this retrospective series, the majority of patients were treated with newer oral antipsychotics. Administration of multiple medications was associated with a significantly longer length of stay in the ED, as was parenteral administration of antipsychotics.
7
Yoo, Junsang, Jeonghoon Lee, Poong-Lyul Rhee, Dong Kyung Chang, Mira Kang, Jong Soo Choi, David W. Bates, and Won Chul Cha. "Alert Override Patterns With a Medication Clinical Decision Support System in an Academic Emergency Department: Retrospective Descriptive Study." JMIR Medical Informatics 8, no. 11 (November 4, 2020): e23351. http://dx.doi.org/10.2196/23351.
Full textAbstract:
Background Physicians’ alert overriding behavior is considered to be the most important factor leading to failure of computerized provider order entry (CPOE) combined with a clinical decision support system (CDSS) in achieving its potential adverse drug events prevention effect. Previous studies on this subject have focused on specific diseases or alert types for well-defined targets and particular settings. The emergency department is an optimal environment to examine physicians’ alert overriding behaviors from a broad perspective because patients have a wider range of severity, and many receive interdisciplinary care in this environment. However, less than one-tenth of related studies have targeted this physician behavior in an emergency department setting. Objective The aim of this study was to describe alert override patterns with a commercial medication CDSS in an academic emergency department. Methods This study was conducted at a tertiary urban academic hospital in the emergency department with an annual census of 80,000 visits. We analyzed data on the patients who visited the emergency department for 18 months and the medical staff who treated them, including the prescription and CPOE alert log. We also performed descriptive analysis and logistic regression for assessing the risk factors for alert overrides. Results During the study period, 611 physicians cared for 71,546 patients with 101,186 visits. The emergency department physicians encountered 13.75 alerts during every 100 orders entered. Of the total 102,887 alerts, almost two-thirds (65,616, 63.77%) were overridden. Univariate and multivariate logistic regression analyses identified 21 statistically significant risk factors for emergency department physicians’ alert override behavior. Conclusions In this retrospective study, we described the alert override patterns with a medication CDSS in an academic emergency department. We found relatively low overrides and assessed their contributing factors, including physicians’ designation and specialty, patients’ severity and chief complaints, and alert and medication type.
8
Puri, V. V., K. Dong, B. H. Rowe, S. W. Kirkland, C. Vandenberghe, G. Salvalaggio, R. Cooper, et al. "LO39: Healthcare costs among homeless and/or substance using adults presenting to the emergency department: a single centre study." CJEM 19, S1 (May 2017): S41. http://dx.doi.org/10.1017/cem.2017.101.
Full textAbstract:
Introduction: Active substance use and unstable housing are both associated with increased emergency department (ED) utilization. This study examined ED health care costs among a cohort of substance using and/or homeless adults following an index ED visit, relative to a control ED population. Methods: Consecutive patients presenting to an inner-city ED between August 2010 and November 2011 who reported unstable housing and/or who had a chief presenting complaint related to acute or chronic substance use were evaluated. Controls were enrolled in a 1:4 ratio. Participants’ health care utilization was tracked via electronic medical record for six months after the index ED visit. Costing data across all EDs in the region was obtained from Alberta Health Services and calculated to include physician billing and the cost of an ED visit excluding investigations. The cost impact of ED utilization was estimated by multiplying the derived ED cost per visit by the median number of visits with interquartile ranges (IQR) for each group during follow up. Proportions were compared using non-parametric tests. Results: From 4679 patients screened, 209 patients were enrolled (41 controls, 46 substance using, 91 unstably housed, 31 both unstably housed and substance using (UHS)). Median costs (IQR) per group over the six-month period were $0 ($0-$345.42) for control, $345.42 ($0-$1139.89) for substance using, $345.42 ($0-$1381.68) for unstably housed and $1381.68 ($690.84-$4248.67) for unstably housed and substance using patients (p<0.05). Conclusion: The intensity of excess ED costs was greatest in patients who were both unstably housed and presenting with a chief complaint related to substance use. This group had a significantly larger impact on health care expenditure relative to ED users who were not unstably housed or who presented with a substance use related complaint. Further research into how care or connection to community resources in the ED can reduce these costs is warranted.
9
Vodonos, Alina, Victor Novack, Israel Waismel-Manor, Yacov Ezra, Adi Guetta, and Gal Ifergane. "Sick of news? Television news exposure, collective stressful events and headache related emergency department visits." PLOS ONE 16, no. 4 (April 8, 2021): e0249749. http://dx.doi.org/10.1371/journal.pone.0249749.
Full textAbstract:
Stress is a well-known trigger for primary headache yet its impact is difficult to demonstrate in large epidemiological studies. Israeli national TV news is often referred to as the “tribal fire”, as many Israelis watch national news coverage following terror attacks or military operations. We examined the association between exposure to television news and their content with headache related Emergency Department visits. This retrospective cohort study included data on daily Emergency Department visits with a chief complaint of headache in Soroka University Medical Center, during 2002–2012. Data on daily television news viewership ratings were obtained from the Israeli Audience Research Board and its content from Channel 2 headlines, the highest rated TV news program. To estimate the short-term effects of news rating during the evening news on the number of daily headache visits, we applied generalized linear mixed models. 16,693 Emergency Department visits were included in the analysis. An increase in five units of daily rating percentages was associated with increase in Emergency Department visits the following day, relative risk (RR) = 1.032, (95% CI 1.014–1.050). This association increased with the age of the patients; RR = 1.119, (95% CI 1.075–1.65) for older than 60-year-old, RR = 1.044 (95% CI 1.010–1.078) for ages 40–60 and RR = 1.000 (95% CI 0.977–1.023) for younger than 40-year-old. We did not find a specific content associated with ED visit for headache. Higher television news ratings were associated with increased incidence of Emergency Department headache related visits. We assume that especially among older persons, news viewership ratings provide an indirect estimate of collective stress, which acts as a headache trigger for susceptible subjects.
10
Fleet, Richard P., Kim L. Lavoie, Jean-Pierre Martel, Gilles Dupuis, André Marchand, and Bernard D. Beitman. "Two-year follow-up status of emergency department patients with chest pain: Was it panic disorder?" CJEM 5, no. 04 (July 2003): 247–54. http://dx.doi.org/10.1017/s1481803500008447.
Full textAbstract:
ABSTRACT Objectives: We previously reported that 25% (108/441) of consecutive patients presenting to the emergency department (ED) of the Montreal Heart Institute with a chief complaint of chest pain suffered from panic disorder (PD). The purpose of the present study was to re-examine these patients (with and without PD) 2 years after their initial ED visit to determine their psychiatric and psychosocial status. Methods: An interviewer, who was kept blind to patients’ initial medical and psychiatric diagnoses, attempted to contact all patients who participated in the initial study by phone. Patients who completed the phone interview were sent a battery of psychological questionnaires by mail. Results: A total of 301 (70%) patients completed the phone interview, and 228 (52%) patients completed the self-report questionnaires. Participants and non-participants did not differ with respect to age, gender, initial self-report scores, or initial cardiac or psychiatric diagnoses. At follow-up, significantly (p < 0.05) more PD+ than non-PD (PD–) patients reported: 1) chest pains in the last month (57% vs. 31%); 2) one or more ED consultations in the past year for chest pain (40% vs. 14%); 3) one or more hospitalizations in the past year (31% vs. 11%); and 4) perceiving their general health as “poor” (22% vs. 9%). PD+ patients displayed a significant (p < 0.05) worsening of their panic symptoms, agoraphobic avoidance, depression, and trait anxiety, and reported significantly (p < 0.05) greater suicidal ideation compared to PD– patients (32% vs. 9%). Of all PD+ patients, only 22% (18/82) reported receiving some form of mental health treatment for their symptoms. Conclusions: Unrecognized and untreated PD has a chronic and disabling course. Greater efforts should be made to screen for PD in patients complaining of chest pain in EDs.
11
Bakewell, F., S. Addleman, and V. Thiruganasambandamoorthy. "P010: Use of the emergency department by refugees under the Interim Federal Health Program." CJEM 18, S1 (May 2016): S81—S82. http://dx.doi.org/10.1017/cem.2016.187.
Full textAbstract:
Introduction: In June 2012, the federal government made cuts to the Interim Federal Health (IFH) Program that reduced or eliminated health insurance for refugee claimants in Canada. The purpose of this study was to examine the effect of the cuts on emergency department (ED) use among patients claiming IFH benefits. Methods: We conducted a health records review at two tertiary care EDs in Ottawa. We reviewed all ED visits wherein an IFH claim was made at triage, for 18 months before and 18 months after the changes to the program on June 30, 2012 (2011-2013). Claims made before and after the cuts were compared in terms of basic demographics, chief presenting complaints, acuity, diagnosis, presence of primary care, and financial status of the claim. Results: There were a total of 612 IFH claims made in the ED from 2011-2013. The demographic characteristics, acuity of presentation and discharge diagnosis were similar during both the before and after periods. Overall, 28.6% fewer claims were made under the IFH program after the cuts. Of the claims made, significantly more were rejected after the cuts than before (13.7% after vs. 3.9% before, p<0.05). The majority (75.0%) of rejected claims have not been paid by patients. Fewer patients after the cuts indicated that they had a family physician (20.4% after vs. 30% before, p<0.05) yet a higher proportion of these patients were still advised to follow up with their family doctor during the after period (67.2% after vs. 41.8% before, p<0.05). Conclusion: A higher proportion of both rejected and subsequently unpaid claims after the IFH cuts in June 2012 represents a potential barrier to emergency medical care, as well as a new financial burden to be shouldered by patients and hospitals. A reduction in IFH claims in the ED and a reduction in the number of patients with access to a family physician also suggests inadequate care for this population. Yet, the lack of primary care was not reflected in the follow-up advice offered by ED physicians to patients.
12
Jitta, A. Josephus. "Dutch Medical Examiner/Coroner's Euthanasia Report Form." Cambridge Quarterly of Healthcare Ethics 2, no. 1 (1993): 36–37. http://dx.doi.org/10.1017/s0963180100000591.
Full textAbstract:
This document was developed by prosecutor A. Josephus Jitta, Chief, Office of Justice, Alkmaar, The Netherlands, with assistance from physicians and is typical of the euthanasia report forms completed by medical examiners and coroners In The Netherlands.
13
Haykal, Tarek, Ragheed Al-Dulaimi, Josiane Kerbage, Varun Samji, Sowmya Goranta, Smit Deliwala, and Ghassan Bachuwa. "Characteristics and Trends of Sickle Cell Disease Patients Once Presented to the Emergency Department, Reflecting on a Possible Burden: United States (2010-2015)." Blood 134, Supplement_1 (November 13, 2019): 4845. http://dx.doi.org/10.1182/blood-2019-126871.
Full textAbstract:
Background: Sickle cell disease (SCD) is an autosomal recessive, multisystem disorder, characterized by chronic hemolytic anemia, painful episodes of vaso-occlusion, progressive organ failure and a reduced life expectancy. SCD is the most common monogenetic disease, with millions affected worldwide. It is estimated that there are 100,000 people living with SCD in the United States (US). Patients with SCD often use emergency department (ED) services to obtain medical care. Limited nationwide information in the recent years is available about ED use among patients with SCD. Methods: Data from the National Hospital Ambulatory Medical Care Survey (NHAMCS) for the years 2010-2015 were analyzed, to examine the prevalence and care of SCD patients in the EDs across the US. The NHAMCS is a survey of hospital ED and outpatient visits. Cases were identified using ICD 9 codes and all analyses accounted for complex survey structure of the data. Results: On average, approximately 1.4 million ED visits were estimated to have occurred between the years 2010 and 2015 with SCD as one of the diagnoses listed, where 860,000 were attributed to sickle cell crises. 37.29% were of female sex while 62.71% were males. 11.62% were under 15 years of age, 28.22% were between 15 and 24 years of age, 51.15% were between the ages of 25 and 44 years and 9.02% were older than 45 years. The chief complaint for the majority of cases was pain. The expected source of payment were Medicare and Medicaid at 30.45% and 41.98% respectively, while private insurance coverage and self-pay were only at 11.71% and 5.81% respectively. Of all SCD ED visits, 68.5% were considered as initial presentations and up to 23.37% were considered as follow-up. 33.31% of the visits ended up needing a hospital admission while 66.69% got discharged from the ED.In 43.39% of the visits, a form of imaging was ordered, compared to 56.61% where it was not. Upon getting triaged in the ED, 67.62% of all SCD visits needed either emergent or urgent medical attention, while the rest were either none-urgent, or a regular check-up. Conclusion: In well-resourced countries, like the US, comprehensive care programs have increased life expectancy of sickle cell disease patients, with almost all infants surviving into adulthood. However unfortunately with poor control of the disease due to limited therapeutic options and with growing morbidity for the aging SCD patients, the burden on the medical system becomes extremely high. Our study highlights the significant burden SCD creates in the EDs across the US based on data collected from a national database. Disclosures No relevant conflicts of interest to declare.
14
Kim, Donna H., Dongseok Choi, and Thomas S. Hwang. "Current Models for Inpatient and Emergency Room Ophthalmology Consultation in U.S. Residency Programs." Journal of Academic Ophthalmology 12, no. 02 (July 2020): e171-e174. http://dx.doi.org/10.1055/s-0040-1717064.
Full textAbstract:
Abstract Objective This article examines models of patient care and supervision for hospital-based ophthalmology consultation in teaching institutions. Design This is a cross-sectional survey. Methods An anonymous survey was distributed to residency program directors at 119 Accreditation Council for Graduated Medical Education accredited U.S. ophthalmology programs in the spring of 2018. Survey questions covered consult volume, rotational schedules of staffing providers, methods of supervision (direct vs. indirect), and utilization of consult-dedicated didactics and resident competency assessments. Results Of the 119 program directors, 48 (41%) completed the survey. Programs most frequently reported receiving 4 to 6 consults per day from the emergency department (27, 55.1%) and 4 to 6 consults per day from inpatient services (26, 53.1%). Forty-seven percent of programs reported that postgraduate year one (PGY-1) or PGY-2 residents on a dedicated consult rotation initially evaluate patients. Supervising faculty backgrounds included neuro-ophthalmology, cornea, comprehensive, or a designated chief of service. Staffing responsibility is typically shared by multiple faculty on a daily or weekly rotation. Direct supervision was provided for fewer of emergency room consults (1–30%) than for inpatient consults (71–99%). The majority of programs reported no dedicated didactics for consultation activities (27, 55.1%) or formal assessment for proficiency (33, 67.4%) prior to the initiation of call-related activities without direct supervision. Billing submission for consults was inconsistent and many consults may go financially uncompensated (18, 36.7%). Conclusion The majority of hospital-based ophthalmic consultation at academic centers is provided by a rotating pool of physicians supervising a lower level resident. Few programs validate increased levels of graduated independence using specific assessments.
15
Poudel, Sabin, Pranoti Sinha, and Karma Lakhi Bhutia. "Morphometric Measurement of Sacral Hiatus in Dry Human Sacrum." Journal of Health and Allied Sciences 10, no. 2 (October 15, 2020): 73–77. http://dx.doi.org/10.37107/jhas.169.
Full textAbstract:
Introduction: Sacral hiatus is the chief location for caudal epidural anesthesia during surgery of perineal region and also for a pain free parturition. Thus, this study was conducted to examine, measure and record the morphometry of sacral hiatus and to analyze it for any anatomical variations with clinical implications.
Methods: The cross-sectional study was carried in the Department of Anatomy, Sikkim Manipal Institute of Medical Science, Gangtok, Sikkim. For the study seventy dry human sacral bone with entire sacral hiatus were measured. The shape of the sacral hiatus was observed. Level of the apex, base, length, width and anterior posterior diameter of sacral hiatus was measured with Digital Vernier Caliper. The study was approved by Institutional Ethical Committee (IEC No:SMIMS/IEC/2017-01). Data were analysed by one-way analysis of variance (ANOVA) and the difference was considered significant when P<0.05. SPSS 20 was used for data analysis.
Results: The study revealed inverted “U” shaped sacral hiatus as the common shape in 35(50%) followed by inverted “V” shaped sacra in 18 (25.71 %) followed by irregular shaped sacral hiatus in 8 (11.42 %) cases. A Dumbbell shaped sacral hiatus was observed in 4 (5.71%) cases with a bony protuberance protruding medially from both edges. Absence or complete agenesis of sacral hiatus, a rare phenomenon, was observed in 3 (4.28%) and bifid in 2(2.85%) specimens only.
Conclusion: The prevalence of inverted “U” shaped sacral hiatus and constriction of the sacral canal at apex of sacral hiatus was found high. This knowledge of variation in shape of sacral hiatus could be clinically important while providing caudal anesthesia and doing epidural block.
16
Gill, James R. "9/11 and the New York City Office of Chief Medical Examiner." Forensic Science, Medicine and Pathology 2, no. 1 (2006): 29–32. http://dx.doi.org/10.1385/fsmp:2:1:29.
Full text
17
Mahabee-Gittens, E. Melinda, Ashley L. Merianos, Eunha Hoh, Penelope JE Quintana, and Georg E. Matt. "Nicotine on Children’s Hands: Limited Protection of Smoking Bans and Initial Clinical Findings." Tobacco Use Insights 12 (January 2019): 1179173X1882349. http://dx.doi.org/10.1177/1179173x18823493.
Full textAbstract:
Background: Thirdhand smoke (THS) pollutants, such as nicotine, accumulate on the hands of children who live in homes with smokers and are exposed to secondhand smoke. Our objective was to examine whether levels of hand nicotine in exposed children are associated with demographics, environmental factors, and clinical findings. Methods: Participants were caregivers who smoke and children (mean age (SD) = 2.6 (3.7) years) who were part of an ongoing 2-group, randomized controlled trial of an emergency department–based tobacco cessation intervention (N = 104). The primary outcome measure was nicotine on the child’s hand. Caregivers reported demographics and smoking patterns; children’s medical records were abstracted for chief complaint, medical history, and diagnoses. Results: All children had detectable hand nicotine (geometric mean [GeoM] = 86.2 ng/wipe; range = 3.5-2, 190.4 ng/wipe). Children in the age group of 2 to 4 years old (GeoM = 185.6 ng/wipe) had higher levels than the children in the age groups of 0 to 1 (GeoM = 68.9 ng/wipe, P < .001), 5 to 9 (GeoM = 77.9 ng/wipe, P = .04), and 10 to 15 years old (GeoM = 74.2 ng/wipe, P = .048). Children whose caregivers smoked 6 to 14 (GeoM = 97.2 ng/wipe, P = .047) and 15 to 40 cigarettes/day (GeoM = 124.0 ng/wipe, P = .01) had higher levels than children whose caregivers smoked 1 to 5 cigarettes/day (GeoM = 59.7 ng/wipe). Children with 6 to 14 cigarettes/day (GeoM = 163.11 ng/wipe, P = .007) and 15 to 40 cigarettes/day (GeoM = 186.1, P = .003) smoked inside the home by all smokers had significantly higher levels than homes with 0 cigarettes (GeoM = 81.3 ng/wipe). Similar differences in hand nicotine levels were found for smoking frequency of all household members in any location. Children with complaints of cough/congestion (GeoM = 97.7 ng/wipe) had higher levels than those without cough/congestion (GeoM = 59.0 ng/wipe, P = .01). Conclusions: The high hand nicotine levels in children whose caregivers do not necessarily smoke indoor demonstrate that indoor smoking bans do not safeguard against THS exposure and the associations with increased home smoking activity indicate that hand wipes may be a noninvasive way to characterize children’s exposure. The findings of associated cough and congestion with higher THS levels need to be examined further.
18
Putri, Linda Wira, and Ardizal Rahman. "LIMFOMA MALIGNA PADA MATA YANG DIRAWAT DI RUMAH SAKIT Dr. M. DJAMIL PADANG TAHUN 2003-2010." Majalah Kedokteran Andalas 35, no. 1 (May 1, 2011): 50. http://dx.doi.org/10.22338/mka.v35.i1.p50-60.2011.
Full textAbstract:
AbstrakMelaporkan kasus Limpoma pada Mata yang dirawat di RS. Dr. M. Djamil Padang.Studi retrospektif dari 17 rekam medik yang didiagnosa sebagai limfoma pada mata di Bagian Mata RSUP dr. M. Djamil antara 2003 – 2010.Terdapat 17 kasus limfoma pada mata di RSUP Dr. M. Djamil antara 2003 – 2010. Pasien laki-laki sebanyak 15 orang dan pasien perempuan 2 orang, dengan usia antara 4 bulan – 71 tahun. Keluhan utama paling sering (82,35%) adalah proptosis pada mata. Semua pasien diperiksa dengan CT scan dan pemeriksaan histopatologis. Tipe limfositik yang paling banyak ditemukan secara histopatologis (64,70%). Semua pasien dianjurkan untuk kemoterapi, tetapi hanya 10 pasien yang menjalani kemoterapi.Proptosis pada mata merupakan tanda yang paling sering dari limfoma maligna pada pasien yang berobat di RSUP Dr. M. Djamil. Tipe limfositik adalah tipe yang paling sering. Tidak semua pasien menjalani kemoterapi karena adanya masalah ekonomi.Kata kunci: Limfoma maligna, limfoma pada mata, proptosisAbstractReporting cases of hospitalized ocular lymphoma at Dr. M. Djamil Hospital from 2003 – 2010.Retrospective study of the medical records of 17 Ocular Lympomas diagnosed patients at the Ophthalmology Department of Dr. M. Djamil Hospital, between 2003 – 2010.There were 17 cases of Ocular Lymphoma at Dr. M. Djamil Hospital between 2003 – 2010. They are 15 male and 2 female patients, in range of age between 4 months to 71 years old. Most of them (82.35%) have chief complaint proptosed of the eye since months to years. All patients were examined using CT imaging and histopatologically. Lymphosityc type was the most type of hystopathological characterictic (64.70%) All patient were suggested to chemotherapy, but only 10 patients received chemotherapy.LAPORAN KASUS51Proptosed of the eye was the most commont sign of malignant lymphoma patient visited at Dr. M. Djamil Hospital. Lymphosityc type was the most common type. Not all patients could receive chemotherapy for they have economic problems.Key word : Malignant lymphoma,ocular lymphoma, proptosis
19
Whitney, Robin L., Janice Bell, Daniel J. Tancredi, Patrick S. Romano, Richard J. Bold, and Jill Joseph. "Inpatient care use among Californian patients with cancer in the year after diagnosis." Journal of Clinical Oncology 35, no. 8_suppl (March 10, 2017): 235. http://dx.doi.org/10.1200/jco.2017.35.8_suppl.235.
Full textAbstract:
235 Background: Inpatient care use is the chief driver of regional spending variation among some cancer patients and contributes more to cancer-related healthcare spending than does any other service category– including costly chemotherapy drugs. However, few studies are available to describe population rates of and reasons for hospitalization. Methods: California Cancer Registry (CCR) data linked with administrative claims data were used to quantify and describe inpatient care use among individuals diagnosed with cancer in California between 2009-2012 (n = 412, 850). Multistate models were used to estimate age-adjusted hospitalization rates, accounting for survival. Characteristics of hospitalizations were described and tabulated, including reasons for admission, procedures, and emergency department (ED) origin. Results: Among individuals with cancer, 62% had at least one hospitalization in the year after diagnosis, nearly half of which originated in the ED (45%). Among individuals with late stage cancers, 73-77% had an admission, 42-66% of which originated in the ED. Many hospitalizations included at least one surgical procedure (54%), diagnostic procedure (24%), or chemotherapy (11%). The most frequent principal diagnoses (other than malignancy) were infection-related (11%), cardiovascular (4%) and complications of a medical device or care (4%). Estimated hospitalization rates were highest for individuals with hepatobiliary/pancreatic cancers (2.5 hospitalizations), bone/soft tissue cancers (2.1 hospitalizations), and digestive system cancers (2.0 hospitalizations), and lowest for individuals with melanoma (0.3 hospitalizations), and breast or prostate cancer (0.6 hospitalizations). Conclusions: The population burden of inpatient care use among individuals with newly diagnosed cancer is substantial. Many hospitalizations originate in the emergency room, suggesting that they are unplanned. Oncology care providers’ efforts to reduce acute care use might target subgroups with higher rates, including hepatobiliary/pancreatic, bone/soft tissue, digestive, and late-stage cancers. Further research is warranted that examines the extent to which such visits are avoidable.
20
Knopf, Alison. "N.H. chief medical examiner is retiring because it's time, not because of ODs." Alcoholism & Drug Abuse Weekly 29, no. 40 (October 16, 2017): 7. http://dx.doi.org/10.1002/adaw.31740.
Full text
21
Vigil, Jacob M., Joe Alcock, Patrick Coulombe, and Chance Strenth. "Emergency Severity Index Scores Differ by Health Provider’s Gender and Patient’s Age." Open Anesthesiology Journal 9, no. 1 (August 27, 2015): 17–22. http://dx.doi.org/10.2174/1874321801509010017.
Full textAbstract:
Background: Experimental research shows that laywomen express higher levels of empathy than men to pain suffering behaviors in others and female practitioners interact with and may prescribe different levels of pain medication to patients than male practitioners. Objectives: In this study we conduct a small medical records review to examine the possibility that female emergency department nurses assign lower levels (i.e., more urgent, serious, resource extensive) of emergency severity index (ESI) scores of patients presenting for care in the emergency department than male nurses, raising the possibility that patients receive disparate treatment during triage depending on the gender of medical staff. Methods: The patient-provided pain scores and the examiner-determined ESI scores of forty-eight male, emergency department patients (21-89yrs, Mage = 57.2, SDage = 19.3) were examined across multiple visits, along with the gender of their triage examiner at each visit of (127 total patient/provider interactions). Results: A cross-classified mixed-effects model to analyze the influence of examiner gender on the triage scores that showed a significant Examiner Gender x Patient Age interaction. Further probing showed that female practitioners ascribed significantly lower ESI scores than male practitioners, although this effect was limited to patients younger than 55 years of age. Conclusion: These findings warrant larger-scale investigations of patient and examiner influences on patient treatment, which are necessary for creating more standardized protocols for reliably assessing emergency-care patients and for reducing health disparities in patient treatment quality.
22
Tharp-Myers, Amy M., Kathrin Hobron, and Ralph Orr. "The Utility of a Prescription Monitoring Program in Death Investigation: The Virginia Experience." Academic Forensic Pathology 7, no. 1 (March 2017): 73–79. http://dx.doi.org/10.23907/2017.008.
Full textAbstract:
The Virginia Prescription Monitoring Program (VPMP) has been in effect since 2002, providing reports for prescribers, pharmacists, and other stakeholders in the growing opioid epidemic. The Office of the Chief Medical Examiner is one such stakeholder and has found great efficacy in the program in investigating suspected drug-related deaths. This review examines the origins of the VPMP, its benefits, and limitations for use during death investigation.
23
Krulewitch, Cara J., Darryl W. Roberts, and Linda S. Thompson. "Adolescent Pregnancy and Homicide: Findings From the Maryland Office of the Chief Medical Examiner, 1994-1998." Child Maltreatment 8, no. 2 (May 2003): 122–28. http://dx.doi.org/10.1177/1077559502250829.
Full text
24
Pokines, James T., Debra Prince Zinni, and Kate Crowley. "Taphonomic Patterning of Cemetery Remains Received at the Office of the Chief Medical Examiner, Boston, Massachusetts." Journal of Forensic Sciences 61 (August 11, 2015): S71—S81. http://dx.doi.org/10.1111/1556-4029.12902.
Full text
25
Calman, Kenneth C. "Letter to the President from the Chief Medical Officer, Department of Health." Psychiatric Bulletin 16, no. 5 (May 1992): 317. http://dx.doi.org/10.1192/pb.16.5.317.
Full text
26
Puri, V. V., K. Dong, B. H. Rowe, S. W. Kirkland, C. Vandenberghe, G. Salvalaggio, R. Cooper, et al. "P106: Healthcare utilization among homeless and/or substance using adults presenting to the ED." CJEM 18, S1 (May 2016): S114. http://dx.doi.org/10.1017/cem.2016.282.
Full textAbstract:
Introduction: Substance use and unstable housing are associated with heavy use of the Emergency Department (ED). This study examined the impact of substance use and unstable housing on the probability of future ED use. Methods: Case-control study of patients presenting to an urban ED. Patients were eligible if they were unstably housed for the past 30 days, and/or if their chief complaint was related to substance use. Following written informed consent, patients completed a baseline survey and health care use was tracked via electronic medical records for the next six months. Controls were enrolled in a 1:4 ratio. More than 2 ED visits during the follow-up was pre-specified as a measure of excess ED use. Descriptive analyses included proportions and medians with interquartile ranges (IQR). Binomial logistic regression models were used to estimate the impact of housing status, high-risk alcohol use (AUDIT) and drug use (DUDIT), and combinations of these factors on subsequent acute care system contacts (ED visits + admissions). We controlled for age, gender, comorbidities at baseline, and baseline presenting acuity. Results: 41 controls, 46 substance using, 91 unstably housed, and 31 both unstably housed and substance using patients were enrolled (n = 209). Median ED visits during follow up were 0 (IQR: 0-1.0) for controls, 1.0 (IQR: 0-3.3) for substance using, 1.0 (IQR: 0-4.0) for unstably housed and 4 (IQR: 2-12.3) for unstably housed and substance using patients. The median acute care system contacts over the same period was 1.0 (IQR 0-2.0) for controls, 1.0 (IQR: 0-4.0) for substance using, 1.0 (IQR: 0-5.0) for unstably housed and 4.5 (IQR: 2.8-14.3) for unstably housed and substance using patients. Being unstably housed was the factor most strongly associated with having > 2 ED visits (b=3.288, p<0.005) followed by high-risk alcohol and drug use (b=2.149, p<0.08); high risk alcohol use alone was not significantly associated with ED visits (b=1.939, p<0.1). The number of comorbidities present at baseline was a small but statistically significant additional risk factor (b=0.478, p<0.05). The model correctly predicted 70.1% of patients’ ED utilization status. Conclusion: Unstable housing is a substantial risk factor for ED use; high-risk alcohol and drug use, and comorbidities at baseline increased this risk. The intensity of excess ED use was greatest in patients who were unstably housed and substance using.
27
Panin, V. F., and V. I. Cherednikova. "Professor Fedor Grigoryevich Krotkov – chief hygienist of the Red Army." Radiatsionnaya Gygiena = Radiation Hygiene 13, no. 1 (March 31, 2020): 84–90. http://dx.doi.org/10.21514/1998-426x-2020-13-1-84-90.
Full textAbstract:
The article provides brief information about the life and working activities of the first head of the Department of Radiation Hygiene of the Central Institute for Advanced Medical Training, academician, Doctor of Medical Sciences, Professor, Major General of the medical service F. G. Krotkov in the field of military hygiene during its formation in the Soviet health care, in the pre-war years and during the great Patriotic War. The direction of the scientific work of F. G. Krotkov at the Department of hygiene of the Military Medical Academy and contribution to the basis of the Aviation Scientific Research Institute of Sanitary in the WorkerPeasant Red Army and the Special Food Research Institute of the Red Army and its role in improving the combat capability of the Army and Navy as the head of the sanitary Department of the Main military-sanitary Directorate of the Red Army. It also reflects the activities of Professor F. G. Krotkov on the development of radiation hygiene as the head of the country’s first specialized Department in the Central Institute for Advanced Medical Training. The paper provides information on perpetuate the name of Professor Krotkov on his small Home in S. Mosolovo, the Ryazan oblast and in Moscow city, where he worked for many years.
28
Jia, Lena, Michael Kevin Rooney, Clare Jacobson, Kent A. Griffith, Reshma Jagsi, and Merry Jennifer Markham. "Factors associated with endowed chair allocation in medical oncology divisions and departments in the United States." Journal of Clinical Oncology 39, no. 15_suppl (May 20, 2021): 11044. http://dx.doi.org/10.1200/jco.2021.39.15_suppl.11044.
Full textAbstract:
11044 Background: Despite an increasing number of female physicians in the workforce, a gender disparity remains in many leadership roles in medicine. Endowed chairs can provide a multitude of research and career opportunities; thus, they are coveted positions in academic medicine. We examined factors associated with holding endowed chairs in oncology across the US, with a focus on whether a gender difference existed, as has been demonstrated in top internal medicine departments more generally. Methods: In 2019, we identified 95 academic oncology divisions/departments in the US, using the Oncology Division Chiefs & Department Chairs listing in the American Society of Clinical Oncology (ASCO) myConnection forum to define the institutions included. We requested a list of full professors and endowed chairs in those divisions/departments, relying on public data on websites when an institution did not respond. Using public data (e.g., institutional websites, NIH reporter, Scopus, state licensing boards), we collected information on gender, degree, total NIH funding as PIs, H-indices, publication and citation numbers, and graduation year for these individuals. We then created a multivariable logistic regression model to examine if, after controlling for other variables, gender was independently associated with an increased likelihood of holding an endowed chair. Results: One thousand thirty-three oncology full professors were identified, 290 (25.6%) of whom held endowed chairs. Overall, and in an adjusted model, greater research productivity (as measured through publications, citations, and h-index) and greater levels of NIH funding were significantly associated with having an endowed chair. Gender was not significantly associated with endowed chair status (21.9% [95% CI:17.2-27.3] of females and 26.8% [23.8-29.9] for males held endowed chairs; p = 0.11) on bivariable analysis, nor was it significant in the adjusted multivariable model (p = 0.50). Power to detect the observed difference given the total number of professors and their gender distribution was found to be ̃53%, suggesting a 47% chance of failing to reject the null hypothesis of equal gender distributions in endowed chairs when the observed difference is as large as estimated. Conclusions: Among oncology full professors, gender was not significantly associated with endowed chair status, although the number of professors in this field is too small to definitively rule out a modest gender difference. This finding contrasts with prior work that revealed a more substantial difference by gender that remained significant after controlling for other factors in a study, including all divisions in the Departments of Internal Medicine at top medical institutions. Further work is necessary to understand what specialty-specific and institutional cultural factors may help mitigate challenges in the pursuit of equity, diversity, and inclusion.
29
Bishop-Freeman, Sandra C., Roger L. Bertholf, Robert H. Powers, Lisa C. Mayhew, and Ruth E. Winecker. "False-Positive Enzymatic Alcohol Results in Perimortem Specimens." Laboratory Medicine 51, no. 4 (January 30, 2020): 394–401. http://dx.doi.org/10.1093/labmed/lmz082.
Full textAbstract:
Abstract Herein, we present 2 cases referred to the North Carolina Office of the Chief Medical Examiner (NC OCME) in which ethanol results reported by different hospital laboratories, using alcohol dehydrogenase (ADH)–based assays, were positive, whereas results of headspace gas chromatography testing performed in the NC OCME laboratory were negative. Literature reports suggest that false-positive ethanol measurements from ADH-based assays can occur when a combination of elevated lactate and lactate dehydrogenase (LD) are present in the specimen. The results were reported in perimortem specimens collected from 2 children with unrelated medical conditions. The cases and associated clinical parameters are considered based on the lactate/LD explanation for the false-positive results, to facilitate the recognition of circumstances that can produce erroneous serum ethanol results.
30
Botello, Timothy, Thomas Noguchi, Lakshmanan Sathyavagiswaran, Linda E. Weinberger, and Bruce H. Gross. "Evolution of the Psychological Autopsy: Fifty Years of Experience at the Los Angeles County Chief Medical Examiner-Coroner's Office." Journal of Forensic Sciences 58, no. 4 (March 28, 2013): 924–26. http://dx.doi.org/10.1111/1556-4029.12138.
Full text
31
Wunsch, MD, Martha J., Kent Nakamoto, PhD, Paul A. Nuzzo, MA, George Behonick, PhD, William Massello, MD, and Sharon L. Walsh, PhD. "Prescription drug fatalities among women in rural Virginia: A study of medical examiner cases." Journal of Opioid Management 5, no. 4 (January 29, 2018): 228. http://dx.doi.org/10.5055/jom.2009.0025.
Full textAbstract:
Objective: To evaluate female drug overdose deaths from the Office of the Chief Medical Examiner, Western Virginia (1997-2003) for demographics, medical history, toxicology results, and prescribed medications.Design: Autopsy reports, death investigations, and hospital/physician notes were reviewed for 330 fatal drug poisonings among women. Data were evaluated with both qualitative and quantitative methods.Results: Most decedents were Caucasian (95 percent), their average age was 42.8 years, and the predominant manner and cause of death was accidental and polydrug toxicity, respectively. Drugs were identified on toxicology or assigned as a cause of death in all 330 cases. The three most common drug classes detected on toxicology were opioids (n = 239; 72.4 percent), antidepressants (n = 201; 60.9 percent), and sedative/anxiolytic/muscle relaxant (SAMR) (n = 161; 48.8 percent) with all three drug classes detected in 89 (27 percent) cases. Illicit drugs identified included cocaine (n = 33; 10 percent) and heroin (n = 3; 0.9 percent). Prescriptions for opioids, SAMR, and antidepressants were found in decedent name in 48 percent, 67.1 percent, and 58 percent of cases, respectively, and 46.1 percent of cases were prescribed at least one medication from each of those three drug classes.Conclusion: Although many decedents held prescriptions, and often for multiple drugs, toxicological findings indicate the frequent presence of other therapeutic drugs in the absence of a prescription. Moreover, many of these cases held simultaneous prescriptions for which there are known drug interactions. It is likely that misuse, fatal medication errors, abuse, and addiction were factors in the increased numbers of these deaths. Interventions to prevent prescription overdose deaths must involve education of both physicians and patients.
32
Copeland, Arthur R. "Fatal Suicidal Hangings among Prisoners in Jail." Medicine, Science and the Law 29, no. 4 (October 1989): 341–45. http://dx.doi.org/10.1177/002580248902900416.
Full textAbstract:
A study of suicidal death by hanging, which occurred when the victim was in jail, was performed on the case files of the Metropolitan Dade County Medical Examiner Department in Miami, Florida, for the ten-year period July 1978 to July 1988. A total of 23 fatalities occurred. These were categorized epidemiologically A discussion ensues concerning what can be done to prevent such tragedies.
33
Doughty, Robert A., Patricia D. Williams, Timothy P. Brigham, and Charles Seashore. "Experiential Leadership Training for Pediatric Chief Residents: Impact on Individuals and Organizations." Journal of Graduate Medical Education 2, no. 2 (June 1, 2010): 300–305. http://dx.doi.org/10.4300/jgme-02-02-30.
Full textAbstract:
Abstract Background The past decade has seen a proliferation of leadership training programs for physicians that teach skills outside the graduate medical education curriculum. Objective To determine the perceived value and impact of an experiential leadership training program for pediatric chief residents on the chief residents and on their programs and institutions. Methods The authors conducted a retrospective study. Surveys were sent to chief residents who completed the Chief Resident Training Program (CRTP) between 1988 and 2003 and to their program directors and department chairs asking about the value of the program, its impact on leadership capabilities, as well as the effect of chief resident training on programs and institutions. Results Ninety-four percent of the chief residents and 94% of program directors and department chairs reported that the CRTP was “very” or “somewhat” relevant, and 92% of the chief residents indicated CRTP had a positive impact on their year as chief resident; and 75% responded it had a positive impact beyond residency. Areas of greatest positive impact included awareness of personality characteristics, ability to manage conflict, giving and receiving feedback, and relationships with others. Fifty-six percent of chief residents reported having held a formal leadership position since chief residency, yet only 28% reported having received additional leadership training. Conclusion The study demonstrates a perceived positive impact on CRTP participants and their programs and institutions in the short and long term.
34
Dzau, Victor J. "Bench to Bedside Discovery, Innovation, Global Health Equity, and Security." Circulation 143, no. 11 (March 16, 2021): 1076–80. http://dx.doi.org/10.1161/circulationaha.121.054151.
Full textAbstract:
Dr Dzau was born in Shanghai. He received his Bachelor of Science in Biology and his MD degree from McGill University. He was a medical resident, Chief Resident, and the founding Chief of the Division of Vascular Medicine at the Peter Bent Brigham Hospital (now the Brigham and Women’s Hospital). He moved to Stanford in 1990 as the Chief of the Division of Cardiovascular Medicine and later became Chairman of the Department of Medicine. Six years later, he returned to Harvard Medical School as the Hersey Professor of the Theory and Practice of Medicine and as Chairman of the Department of Medicine at Brigham and Women’s Hospital. He then became the Chancellor for Health Affairs, President, and CEO of the Duke University Medical Center. In 2014, he was elected to become the President of the Institute of Medicine (now the National Academy of Medicine). He is a member of the National Academy of Medicine, the American Academy of Arts and Sciences, and the European Academy of Sciences and Arts.
35
Emanuel, A. V., O. R. Shvabskiy, A. V. Averyanova, and M. S. Maskin. "Leader's competencies. Approaches to effective management of medical organization." Medical alphabet, no. 36 (January 13, 2021): 61–65. http://dx.doi.org/10.33667/2078-5631-2020-36-61-65.
Full textAbstract:
Due to the increasing demands on the heads of medical organizations in terms of ensuring the proper quality of medical care, there is a need to pay more and more attention to the leadership qualities of not only the direct head of the institution. It is equally important to form the leader’s competencies among managers at any level: deputy chief medical oficer, head of the medical department, head nurses, and technical service manager.
36
Griffith, John Clark, and Donna L. Roberts. "How we roll: A fire engine to every call? Fire department resource allocation and firefighter support in the United States." International Journal of Emergency Services 9, no. 3 (August 11, 2020): 409–19. http://dx.doi.org/10.1108/ijes-12-2019-0066.
Full textAbstract:
PurposeEmergency service departments face changing mission requirements, budget constraints and a demanding work environment. This study examined the perceptions of fire chiefs, officers and firefighters who attended the National Professional Development Symposium on the use of a tiered approach when responding to calls, the continued increase in medical calls and mental health services available to fire service personnel.Design/methodology/approachThis study examined the perceptions of fire chiefs, officers and firefighters who attended the National Professional Development Symposium on the use of a tiered approach when responding to calls, the continued increase in medical calls and mental health services available to fire service personnel.FindingsSurvey respondents indicated that they either are currently or would consider using a tiered approach to sending a fire engine and crew or a lighter vehicle to medical or other calls based requirements identified using a tiered approach.Research limitations/implicationsThis idea has future implications regarding the vehicle mix of fire stations as administrators seek to meet the needs of the public most effectively. Survey responses also noted the need for mental health services arguing that care seeking firefighters should have the option of getting mental health services within the station or at an external location. Calls involving babies or young children were overwhelming cited as the most difficult. Additionally, 95% of respondents indicated a belief that most firefighters suffer from PTSD.Practical implicationsRecommendations include: A larger scale survey and analysis of first responder perceptions based on this study. Identifying “best practices” of the most effective “tiered response” approaches to deploying emergency services resources to calls. Studying Mental Health services combating PTSD to identify best practices. Lastly, emergency services administrators should consider changes to the “vehicle mix” when equipping or reequipping stations.Social implicationsSocial implications include use of a “tiered response” approach to emergency calls and focusing how best to support the mental health needs of firefighters.Originality/valueFire Departments are only beginning to explore the idea of using a tiered response to respond to emergencies. This study identifies both short and long term implications of using a tired approach. A secondary emphasis of this study explores difficult calls and PTSD issues faced by firefighters.
37
Priemer, David S., and Rebecca D. Folkerth. "Dementia in the Forensic Setting: Diagnoses Obtained Using a Condensed Protocol at the Office of Chief Medical Examiner, New York City." Journal of Neuropathology & Experimental Neurology 80, no. 8 (August 1, 2021): 724–30. http://dx.doi.org/10.1093/jnen/nlab059.
Full textAbstract:
Abstract Individuals with dementia may come to forensic autopsy, partly because of non-natural deaths (e.g. fall-related), and/or concerns of abuse/neglect. At the New York City Office of Chief Medical Examiner (NYC OCME), brains from such cases are submitted for neurodegenerative disease (ND) work-up. Seventy-eight sequential cases were evaluated using a recently published condensed protocol for the NIA-AA guidelines for the neuropathologic assessment of Alzheimer disease (AD), a cost-cutting innovation in diagnostic neuropathology. ND was identified in 74 (94.9%) brains; the most common were AD (n = 41 [52.5%]), primary age-related tauopathy (n = 26 [33.3%]), and Lewy body disease ([LBD], n = 25 [32.1%]). Others included age-related tau astrogliopathy, hippocampal sclerosis of aging, progressive supranuclear palsy, multiple system atrophy, amyotrophic lateral sclerosis, argyrophilic grain disease, and Creutzfeldt-Jakob disease. 26.8% of AD cases involved a non-natural, dementia-related death, versus 40.0% for LBD. Finally, 70 (89.7%) cases had chronic cerebrovascular disease, 53 (67.9%) being moderate-to-severe. We present a diverse distribution of NDs notable for a high rate of diagnoses associated with falls (e.g. LBD), a potential difference from the hospital neuropathology experience. We also report a high burden of cerebrovascular disease in demented individuals seen at the NYC OCME. Finally, we demonstrate that the aforementioned condensed protocol is applicable for a variety of ND diagnoses.
38
Lee, Hyun Chul, Yu Kyung Kim, Jung Hup Song, and Kyung Eun Song. "Proposal of Laboratory Test Panel Based on Patients’ Chief Complaints in Emergency Department." Annals of Laboratory Medicine 30, no. 4 (August 1, 2010): 444–50. http://dx.doi.org/10.3343/kjlm.2010.30.4.444.
Full text
39
Siochi, R. Alfredo C., Collin D. Brack, and Colin G. Orton. "The Chief Information Technology Officer in a Radiation Oncology department should be a medical physicist." Medical Physics 36, no. 9Part1 (August 11, 2009): 3863–65. http://dx.doi.org/10.1118/1.3168969.
Full text
40
Shirakawa, Toru, Tomohiro Sonoo, Kentaro Ogura, Ryo Fujimori, Konan Hara, Tadahiro Goto, Hideki Hashimoto, Yuji Takahashi, Hiromu Naraba, and Kensuke Nakamura. "Institution-Specific Machine Learning Models for Prehospital Assessment to Predict Hospital Admission: Prediction Model Development Study." JMIR Medical Informatics 8, no. 10 (October 27, 2020): e20324. http://dx.doi.org/10.2196/20324.
Full textAbstract:
Background Although multiple prediction models have been developed to predict hospital admission to emergency departments (EDs) to address overcrowding and patient safety, only a few studies have examined prediction models for prehospital use. Development of institution-specific prediction models is feasible in this age of data science, provided that predictor-related information is readily collectable. Objective We aimed to develop a hospital admission prediction model based on patient information that is commonly available during ambulance transport before hospitalization. Methods Patients transported by ambulance to our ED from April 2018 through March 2019 were enrolled. Candidate predictors were age, sex, chief complaint, vital signs, and patient medical history, all of which were recorded by emergency medical teams during ambulance transport. Patients were divided into two cohorts for derivation (3601/5145, 70.0%) and validation (1544/5145, 30.0%). For statistical models, logistic regression, logistic lasso, random forest, and gradient boosting machine were used. Prediction models were developed in the derivation cohort. Model performance was assessed by area under the receiver operating characteristic curve (AUROC) and association measures in the validation cohort. Results Of 5145 patients transported by ambulance, including deaths in the ED and hospital transfers, 2699 (52.5%) required hospital admission. Prediction performance was higher with the addition of predictive factors, attaining the best performance with an AUROC of 0.818 (95% CI 0.792-0.839) with a machine learning model and predictive factors of age, sex, chief complaint, and vital signs. Sensitivity and specificity of this model were 0.744 (95% CI 0.716-0.773) and 0.745 (95% CI 0.709-0.776), respectively. Conclusions For patients transferred to EDs, we developed a well-performing hospital admission prediction model based on routinely collected prehospital information including chief complaints.
41
Copeland, Arthur R. "Suicide among the Elderly—The Metro-Dade County Experience, 1981–83." Medicine, Science and the Law 27, no. 1 (January 1987): 32–36. http://dx.doi.org/10.1177/002580248702700106.
Full textAbstract:
A study of suicide victims in those aged 65 years or more was done from the case files of the Medical Examiner Department of Metropolitan Dade County, Miami, Florida, during the years 1981, 1982, and 1983. A total of 222 cases were collected and analysed as to the age, race, sex, and cause of death of the victim along with blood alcohol content, toxicology, locale of the terminal incident, whether or not there was a suicide note, and the reason for depression. The latter most frequently was the victims' concern over their health.
42
Grebenkov, S. V. "NAVAL HYGIENIST PROFESSOR I. V. PETREEV (SCIENTIFIC AND HISTORICAL REVIEW IN VIEW OF 55TH ANNIVERSARY OF THE BIRTH)." Marine Medicine 4, no. 3 (October 7, 2018): 36–50. http://dx.doi.org/10.22328/2413-5747-2018-4-3-36-50.
Full textAbstract:
Scientific and historical reviewis dedicated to naval hygienist, head of a Department of Naval and Radiation Hygiene (2006–2013) in Military Medical Academy named after S. M. Kirov, holder of Habilitation degree in Medicine, professor Igor Vitalievich Petreev who turned 55 years. He has been working in Military Medical Academy for over 25 years. His contribution to the development of hygieology is that he formed a concept of multi-level optimization of hygienic quality forming for military personnel (2007) in the habilitational thesis. Also here viewed and explainedlist and types of advanced means intended on prevention of world ocean waters pollution from naval ships and vessels (1995). In addition he was initiator and co-author of two-volume guidance on naval and radiation hygiene, multimedia reference-training program «Environmental and health basics of health protection in military» (2001, 2002, 2007) and more than 20 guides. Also he co-authored biography monographs «Notebook of naval hygienists» (2012), «The first Russian Department of hygiene» (2015) and set of articles round the history of a Department of Naval and Radiation Hygiene. His military history sheet states only 2 home stations: Pacific Fleet — chief medical officer of submarine from 1988 to 1992 (Bolshoi Kamen and Petropavlovsk-Kamchatsky-53) and Military Medical Academy named after S. M. Kirov (Leningrad, Saint-Petersburg) — cadet (1982), adjunct (1992), lecturer (1995), as sistant professor (2003), chief of a department (2006), head of a department (2011) of Naval and Radiation Hygiene, since 2013 — professor of a Department (of common and military hygiene with the course of naval and radiation hygiene). Military service of professor I. V. Petreev ended in 2011 when the only one in the country Department of Naval and Radiation Hygiene became civil. After demobilization Igor Vitalievich teaches in Military Medical Academy to the present day.
43
Andreev, Alexander Alekceevich, and Anton Petrovich Ostroushko. "Yuri Fedorovich ISAKOV - academician of the USSR Academy of medical Sciences and Russian Academy of Sciences, three times laureate of the State prizes, chief pediatric surgeon of the USSR and the Russian Federation, Deputy Minister of health of the USSR (to the 95th anniversary from birthday)." Vestnik of Experimental and Clinical Surgery 11, no. 2 (June 30, 2018): 149. http://dx.doi.org/10.18499/2070-478x-2018-11-2-149.
Full textAbstract:
Yuri F. Isakov was born in 1923 in the city of Kovrov of the Vladimir region. Participated in the great Patriotic war. In 1951 he graduated from the medical faculty, 1951-1953. – Intern, post – graduate student of Department of pediatric surgery of the 2nd Moscow medical Institute. In 1955 he defended his candidate thesis on "Intravenous and intraosseous anesthesia in operations on the extremities in children", in 1963 – his doctoral thesis on the topic: "Hirschsprung's Disease in children (pathogenesis, clinic, treatment)". In 1964 he became Professor, and in 1966 head of the Department of surgical diseases of childhood of the 2nd Moscow medical Institute and was appointed chief pediatric surgeon, head of the Main Department of educational institutions of the Ministry of health of the USSR. Under his leadership, held a number of progressive reforms, including was introduced biennial specialisation, adapted to the tasks of practical health care curricula, the initiative was created by the initiative of the all-Union children's surgical centre. Since 1981, Yuri F. Isakov, Deputy Minister of health of the USSR, 1989 – Vice-President, Academy of medical Sciences of the USSR (later the Russian Academy of medical Sciences), 1993-2005 was chief pediatric surgeon of the Ministry of health of Russia. He was Chairman of the Presidium of the Russian Association of pediatric surgeons, the Bureau of the scientific Council on pediatric surgery of the Ministry of health of the Russian Federation and the Russian Academy of medical Sciences, editor-in-chief of the journal "Pediatric surgery", Advisor of the Presidium of the Russian Academy of medical Sciences. Yuri Isakov is the author of over 400 scientific works, including 23 monographs, 8 textbooks and manuals, 12 inventions. Yuri F. Isakov died on August 4, 2016 in Moscow, Troekurov buried at a cemetery.
44
Ismagilov, M. F. "The first editor-in-chief of the journal "Neurological Bulletin" prof. V. M. Bekhterev." Neurology Bulletin XXX, no. 1-2 (March 15, 1998): 5–6. http://dx.doi.org/10.17816/nb79858.
Full textAbstract:
In January 1893, the medical community in Russia received a new medical journal. It was Neurological Bulletin, published in Kazan under the editorship of V.M. Bekhterev (head of the Department of Psychiatry at Kazan University) as the organ of the Society of Neuropathologists and Psychiatrists.
45
Sundaresan, Agnes, Gargi Schneider, Joy Reynolds, and H. Kirchner. "Identifying Asthma Exacerbation-Related Emergency Department Visit Using Electronic Medical Record and Claims Data." Applied Clinical Informatics 09, no. 03 (July 2018): 528–40. http://dx.doi.org/10.1055/s-0038-1666994.
Full textAbstract:
Background Asthma exacerbation leading to emergency department (ED) visit is prevalent, an indicator of poor control of asthma, and is a potentially preventable clinical outcome. Objective We propose to utilize multiple data elements available in electronic medical records (EMRs) and claims database to create separate algorithms with high validity for clinical and research purposes to identify asthma exacerbation-related ED visit among the general population. Methods We performed a retrospective study with inclusion criteria of patients aged 4 to 40 years, a visit to Geisinger ED from January 1, 2006, to October 28, 2013, with asthma on their problem list. Different electronic data elements including chief complaints, vitals, season, smoking, medication use, and discharge diagnoses were obtained to create the algorithm. A stratified random sample was generated to select the charts for review. Chart review was performed to classify patients with asthma-related ED visit, that is, the gold standard. Two reviewers performed the chart review and validation was done on a small subset. Results There were 966 eligible ED visits in the EMR sample and 731 in the claims sample. Agreement between reviewers was 95.45% and kappa statistic was 0.91. Mean age of the EMR sample was 22 years, and mostly white (93%). Multiple models conventionally used in studies were evaluated and the final model chosen included principal diagnosis, bronchodilator, and steroid use for both algorithms, chief complaints for EMR, and secondary diagnosis for claims. Area under the curve was 0.93 (95% confidence interval: 0.91–0.94) and 0.94 (0.93–0.96), respectively, for EMR and claims data, with positive predictive value of > 94%. The algorithms are visually presented using nomograms. Conclusion We were able to develop two separate algorithms for EMR and claims to identify asthma exacerbation-related ED visit with excellent diagnostic ability and varying discrimination threshold for clinical and research purposes.
46
Svistushkin, Valery M. "Otitis externa: applied issues." Pediatrics. Consilium Medicum, no. 2 (June 15, 2021): 165–69. http://dx.doi.org/10.26442/26586630.2021.2.201005.
Full textAbstract:
Interview with Valery M. Svistushkin, MD, Professor, Director of the Clinic ofDiseasesof theEar,ThroatandNose and Head of the Department of Ear, Nose and Throat Diseases of the I.M. Sechenov First Moscow State Medical University, Chief Outpatient Otorhinolaryngologist of the Central Federal District of Russia
47
Hardesty, Douglas A., Michael A. Mooney, Benjamin K. Hendricks, Joshua S. Catapano, Scott T. Brigeman, Michael A. Bohl, John P. Sheehy, and Andrew S. Little. "Postoperative 30-day emergency department utilization after 7294 cranial neurosurgery procedures at a tertiary neuroscience center." Journal of Neurosurgery 135, no. 3 (September 2021): 934–42. http://dx.doi.org/10.3171/2020.8.jns202404.
Full textAbstract:
OBJECTIVE Hospital readmission and the reduction thereof has become a major quality improvement initiative in organized medicine and neurosurgery. However, little research has been performed on why neurosurgical patients utilize hospital emergency rooms (ERs) with or without subsequent admission in the postoperative setting. METHODS This study was a retrospective, single-center review of data for all surgical cranial procedures performed from July 2013 to July 2016 in patients who survived to discharge. The study was approved by the institutional review board of the participating medical center. RESULTS The authors identified 7294 cranial procedures performed during 6596 hospital encounters in 5385 patients. The rate of postoperative ER utilization within 30 days after surgical hospitalization across all procedure types was 13.1 per 100 surgeries performed. The two most common chief complaints were pain (30.7%) and medical complication (18.2%). After identification of relevant surgical and patient factors with univariable analysis, a multivariable backward elimination logistic regression model was constructed in which Ommaya reservoir placement (OR 2.65, p = 0.0008) and cranial CSF shunt placement (OR 1.40, p = 0.0001) were associated with increased ER utilization. Deep brain stimulation electrode placement (OR 0.488, p = 0.0004), increasing hospital length of stay (OR 0.935, p < 0.0001), and increasing patient age (OR 0.988, p < 0.0001) were associated with lower rates of postoperative ER utilization. One-half (50%) of ER visit patients were readmitted to the hospital. New/worsening neurological deficit chief complaint (OR 1.99, p = 0.0088), fever chief complaint (OR 2.41, p = 0.0205), altered mentation chief complaint (OR 2.71, p = 0.0002), patient chronic kidney disease (OR 3.31, p = 0.0037), brain biopsy procedure type (OR 3.50, p = 0.0398), and wound infection chief complaint (OR 31.4, p = 0.0008) were associated with increased rates of readmission to the hospital from the ER in multivariable analysis. CONCLUSIONS The authors report the rates of and reasons for ER utilization in a large cohort of postoperative cranial neurosurgical patients. Factors identified were associated with both increased and decreased use of the ER after cranial surgery, as well as variables associated with readmission to the hospital after postoperative ER visitation. These findings may direct future quality improvement via prospective implementation of care pathways for high-risk procedures.
48
Ferguson, Colin. "Establishing a Professional Affairs Board in Wales." Bulletin of the Royal College of Surgeons of England 92, no. 5 (May 1, 2010): 154–55. http://dx.doi.org/10.1308/147363510x499161.
Full textAbstract:
Establishing a professional affairs board (PAB) will be different in each of the regions of the UK but presents particular challenges in Wales. The NHS is very important to the Welsh Assembly Government (WAG). It has its own Department of Health; Minister; Director General, Health and Social Services; Chief Medical Officer; Medical Director; and the panoply of government.
49
Kulnev, V. A., A. M. Shelepov, and O. A. Kruchkov. "The Department of organization and tactics of medical service. Past, present, future." Bulletin of the Russian Military Medical Academy 22, no. 1 (December 15, 2020): 215–19. http://dx.doi.org/10.17816/brmma25995.
Full textAbstract:
The Department of organization and tactics of medical service, celebrating its 90th anniversary, is a leading department of our alma mater, as well as a leading academic and scientific centre of the Chief Military Medical Directorate of the Russian Federation Ministry of Defence. The department develops applied research tasks in the sphere of organization of medical service and provision of medical services to the Armed Forces of the Russian Federation in peacetime and wartime, engages in preparation of directive documents within its profile, analyses efficiency of medical services provided to the armed troops (forces) in daily activities of the medical service and in combat conditions. The department has always taken an active part in the development, preparation and conduct of research command-post and special tactical exercises in conjunction with the medical service of the Russian Federation Armed Forces, as well as in different stages, including the international stage, of the Military Medical Relay Competition jointly with the medical staff of military districts (fleets), branches and services of the Russian Federation Armed Forces. The department is engaged in serious work aimed at training qualified specialists for the overhead structures of the medical service of the Russian Federation Armed Forces, as well as military medics for the army. Over the 90 years of its existence, the department has developed into five new departments: department of military disciplines (operational- tactical training), department of organization and tactics of naval medical service (with a course of naval fighting equipment), department of medical service control automation with a course in military medical statistics, department of military medical supply and pharmacy, department of organization and economics of military healthcare. Among the significant achievements of the Department of organization and tactics of medical service is the development of a number of department-level training courses and academic disciplines some of which have turned (are turning) into independent departments, educational research schools.
50
Marlinda, Pebriana. "ANALISIS PERENCANAAN KEBUTUHAN TENAGA DOKTER OLEH DINAS KESEHATAN KOTA PEKANBARU." Jurnal Niara 9, no. 2 (January 4, 2017): 71–83. http://dx.doi.org/10.31849/nia.v9i2.2100.
Full textAbstract:
This study addresses the need of medical doctors planning process undertaken by theHealth Deparment in Pekanbaru City. So far inventory step in the planning process under taken only limited data collection and the number of qualified doctorsonly, not to the activity analysis and mapping. In addition,the method that used by health office in Pekanbaru City is not standard, so that the number of doctors exceeds national standards, but it is not appropriate qualifications and uneven distribution.This study is a qualitative research to seeks and understand deeply the secondary data from the documents which related the topics, as well as the primary data obtained from interviews with informant of the research as : Chief of medical department, The head of Human resources division and Chief of health section of Health Services and Referral Association.To analyze the planning needs of medical doctors conducted by the Health Departement Pekanbaru city, the author uses the theory proposed by Noatmodjo (2003: 24), namely: inventory, estimate (forecasting), and the planning, monitoring and evaluation.The conclusion of this research is the planning of the medical doctors’ need which has done by health department of Pekanbaru had through steps as follows: inventory, forecasting (estimate), monitoring and evaluation. But there should be strengthened in every steps and also commitment from pekanbaru government, as preparation of the health master plan, minimum standard services, establishes a special a department of planning and standard operational procedure.