Abstract:
OBJECTIVES:Errors in drug dosing lead to poor patient outcomes and are common in patients with chronic kidney disease (CKD). Because the majority of patients with CKD are being treated by physicians specializing in internal medicine, we studied the awareness and knowledge that internal medicine resident trainees (IMRTs) have regarding the correct dosage of commonly used analgesic and neuropsychotropic medications for patients with CKD. METHODS:We surveyed 353 IMRTs about their awareness of whether a medication needs dose adjustment in patients with CKD and knowledge for medication adjustment by level of glomerular filtration rate. RESULTS:There were high percentages for lack of awareness and knowledge. For analgesics, this lack of awareness/knowledge was highest for acetaminophen (awareness 83.0%, knowledge 90.9%). For neuropsychotropics, this was highest for paroxetine (awareness 74.5%, knowledge 91.5%). Analyses for postgraduate year (PGY) -1 trainees and PGY-2 trainees for analgesics showed higher odds for lack of awareness for tramadol (PGY-1 odds ratio [OR] 2.37, 95% confidence interval [CI] 1.2-4.62, P < 0.05; PGY-2 OR 2.34, 95% CI 1.16-4.72, P < 0.05) and for lack of knowledge for meperedine (PGY-1 OR 4.01, 95% CI 1.81-8.89, P < 0.05; PGY-2 OR 3.30, 95% CI 1.44-7.59, P < 0.05). Nephrology residency rotation for the neuropsychotropic medication of gabapentin showed lower odds for both lack of awareness (OR 0.56, 95% CI 0.32-0.97, P < 0.05) and knowledge (OR 0.52, 95% CI 0.27-0.997, P < 0.05). CONCLUSIONS:Awareness and knowledge are poor among IMRTs for dose adjustments of analgesics and neuropsychotropic medication classes in patients with CKD. There should be a renewed focus during IMRTs' residency on additional nephrology exposure and formal didactic educational training to help them better manage complex treatment regimens to prevent medication dosing errors.
journal_name
South Med Jjournal_title
Southern medical journalauthors
Saad CY,Fogel J,Rubinstein Sdoi
10.14423/SMJ.0000000000000781subject
Has Abstractpub_date
2018-03-01 00:00:00pages
155-162issue
3eissn
0038-4348issn
1541-8243pii
SMJ50509journal_volume
111pub_type
杂志文章abstract::I have reported three case of paraurethral cysts in female neonates. These are uncommon lesions, and urologic evaluation is required to differentiate them from ectopic ureteroceles, urethral diverticula, or paraurethral tumors. Histologic appearance of the cyst epithelium identifies the embryologic origin. The cysts e...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198506000-00035
更新日期:1985-06-01 00:00:00
abstract:OBJECTIVES:Studies have found that some health lines and physician's offices have provided treatment advice other than "call 9-1-1 for an ambulance" to patients who present with a stroke scenario. We assessed the treatment advice given by selected pharmacies in the United States regarding stroke. METHODS:The investiga...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.14423/SMJ.0000000000000262
更新日期:2015-04-01 00:00:00
abstract::An 8 year-old girl had a large congenital nevus involving the posterior thigh, leg, and foot. The nevus on non-weight-bearing areas was resected, and the areas were resurfaced with artificial skin and ultra-thin split-thickness grafts. A good result was ultimately achieved. Our management of this case and the relative...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:
更新日期:2001-03-01 00:00:00
abstract::Diabetic peripheral neuropathy affects 5 to 50% of people with diabetes in the United States. It is a progressive disorder that results in a gradual decrease in peripheral sensation and eventually complete loss of sensation. Patients with diabetic peripheral neuropathy are challenging to treat because of intolerable a...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/01.SMJ.0000060886.57804.2E
更新日期:2003-06-01 00:00:00
abstract::Serial carcinoembryonic antigen (CEA) levels were measured during chemotherapy for metastatic cancer in 94 patients. Criteria for chemotherapy responses were those used by the Central Oncology Group. Patients were classified according to changes in CEA levels and response to chemotherapy. Four categories represented a...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197610000-00008
更新日期:1976-10-01 00:00:00
abstract::We report a case of recurrent Merkel cell carcinoma (MCC) of the upper extremity, treated aggressively with wide local excision, regional lymphadenectomy, and immediate reconstruction. Five years after surgery, there is no clinical or diagnostic evidence of locoregional recurrence or distant disease. The patient's upp...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:
更新日期:2000-03-01 00:00:00
abstract::Phenytoin has traditionally been used for both prophylaxis and acute treatment of alcohol withdrawal seizures. With the exception of a well defined subgroup of withdrawing patients, this may not be appropriate. Chronic anticonvulsant therapy is not indicated without evidence of another underlying seizure diathesis. ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197809000-00015
更新日期:1978-09-01 00:00:00
abstract::Parameters for significant risk of aspiration have been defined as a gastric pH less than 2.5 and/or a volume greater than 25 ml. We investigated the effects of metoclopramide and cimetidine, alone and in combination, on the pH and volume of gastric contents of patients taking nothing by mouth before general anesthesi...
journal_title:Southern medical journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00007611-198611000-00009
更新日期:1986-11-01 00:00:00
abstract::We performed a retrospective study to determine the sensitivity of mammography in detecting breast cancer arising in women with augmented breasts. Of eight women with breast implants in whom breast cancer developed, six had mammograms before biopsy. Only two of the six cancers were identified mammographically (sensiti...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/00007611-199101000-00013
更新日期:1991-01-01 00:00:00
abstract::Septic arthritis is a serious and sometimes fatal complication of rheumatoid arthritis. We have examined the clinical characteristics of 16 patients with infectious arthritis seen during an eight-year period. This represented 0.5% of all admissions to our hospital for patients with rheumatoid arthritis. Although rheum...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198610000-00011
更新日期:1986-10-01 00:00:00
abstract::We studied 67 patients who had operation for perforated peptic ulcer. Operative treatment included plication with omentum (Graham closure) in 27 patients, vagotomy and pyloroplasty in 32 patients, or vagotomy and antrectomy in eight patients, depending on antecedent ulcer history, degree of contamination, and general ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198310000-00006
更新日期:1983-10-01 00:00:00
abstract::Intravesical BCG (bacillus Calmette-Guérin) instillation is a first-line treatment for superficial transitional cell carcinoma of the bladder. A rare but severe complication of BCG immunotherapy is the development of disseminated BCG disease, which can result in miliary pneumonitis, granulomatous hepatitis, soft tissu...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/SMJ.0b013e31815d4047
更新日期:2008-01-01 00:00:00
abstract::The frequency of gastritis in relation to its various predisposing conditions is unclear, as is the respective distribution of damage caused by its predisposing conditions. We studied 100 patients with the endoscopic diagnosis of gastritis. The incidence of gastritis in our university gastroenterology endoscopy servic...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198708090-00005
更新日期:1987-09-01 00:00:00
abstract::Continued improvements in computer technology have led to significant enhancement of clinical teaching. We describe a "digital toolbox" consisting of personally accessible hardware and software products to assist in clinical teaching. The areas covered are computer-assisted diagnosis, digitization and display of clini...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199512000-00003
更新日期:1995-12-01 00:00:00
abstract::Obsessive-compulsive disorder (OCD) is an intriguing, difficult problem characterized by anxiety-producing intrusive thoughts and performance of anxiety-reducing rituals. Current evidence suggests that OCD may be associated with dysregulation of serotonin and dopamine neurotransmission. Numerous early studies involvin...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199403000-00003
更新日期:1994-03-01 00:00:00
abstract:BACKGROUND:Primary care providers (PCPs) have limited training in recognizing common skin disorders, and additional emphasis may be placed on laboratory evaluation, including skin biopsies. METHODS:Primary care providers in Miami, Fla, were surveyed regarding skin biopsy and excision practices and histologic interpret...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:
更新日期:2001-05-01 00:00:00
abstract::When patient records are to be auditied in a program designed to assess the quality of medical care rendered, careful consideration must be given to the cost of the system implemented. Structured data collection and a defined treatment plan are advantageous in facilitating the use of nonphysicians for the majority of ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197610000-00022
更新日期:1976-10-01 00:00:00
abstract::This paper briefly reviews the available evidence for the influence of environmental and occupational factors in the development of cancer of the larynx. Although several occupational exposures have been suggested to play a role in the etiology of this disease, few have been convincingly confirmed. The strong associat...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/00007611-198307000-00020
更新日期:1983-07-01 00:00:00
abstract::We reviewed the records of patients with cecal volvulus at three affiliated hospitals of Eastern Virginia Medical School to elucidate its incidence, patterns of presentation, and current methods of surgical management. We identified 109 patients in whom a discharge diagnosis of intestinal obstruction due to volvulus w...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:
更新日期:1988-10-01 00:00:00
abstract::Urinary incontinence in the elderly is a significant health problem fraught with isolation, depression, and an increased risk of institutionalization and medical complications. Stress urinary incontinence (SUI), the complaint of involuntary loss of urine during effort or exertion or during sneezing or coughing, is the...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/01.SMJ.0000146587.06656.98
更新日期:2005-01-01 00:00:00
abstract::We have described a case of maternal primary aldosteronism in which there is virilization of the female offspring. The most common causes of virilization are considered unlikely on the basis of clinical and laboratory data. The report illustrates the exacerbation of aldosteronism that occurs postpartum and emphasizes ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:
更新日期:1983-04-01 00:00:00
abstract::A previously healthy 38-year-old man was stung multiple times by yellow jackets without any signs of anaphylaxis being observed. An electrocardiogram taken 16 hours later revealed episodes of wandering atrial pacemaker, junctional rhythm, and intermittent premature ventricular contractions. These arrhythmias disappear...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197904000-00030
更新日期:1979-04-01 00:00:00
abstract:OBJECTIVE:This study aimed to identify differences in perceptions between healthcare and non-healthcare personnel when it comes to wearing scrubs in non-healthcare settings. METHODS:An anonymous survey with 11 closed-ended questions sent via e-mail to healthcare students and employees at The University of Texas Health...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.14423/SMJ.0000000000000861
更新日期:2018-09-01 00:00:00
abstract::Two cases are reviewed which presented findings strongly suggesting congenital synostosis between the third metatarsal and third cuneiform bones. Supplementary x-ray films proved these joints to be present and intact. This point, though well known to skeletal radiologists, is worthy of emphasis to nonskeletal radiolog...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:
更新日期:1981-01-01 00:00:00
abstract:BACKGROUND:Our objective was to improve breastfeeding initiation rates at an urban medical center. METHODS:A breastfeeding educational program for health care providers was developed and implemented in 1995. The outcome variable of interest was the change in breastfeeding initiation rate during 2 periods, 1993-1994 an...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:
更新日期:2002-08-01 00:00:00
abstract:OBJECTIVES:Noninvasive assessment of right heart function and hemodynamics in patients with pulmonary arterial hypertension (PAH) is most often performed at rest, whereas the symptoms, in general, present with exertion. Assessment during exertion is limited to symptom assessment and the 6-minute walk distance. We inves...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/SMJ.0b013e3182805165
更新日期:2013-02-01 00:00:00
abstract::Twenty-eight women were tested with a standard three-hour oral glucose tolerance test before and after three years of using a combination-type oral contraceptive containing mestranol and ethynodiol diacetate (Ovulen). At the three-year test time there was a significant elevation of the patients' weights and their 1-, ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197710000-00010
更新日期:1977-10-01 00:00:00
abstract::A 76-year-old man with chronic obstructive pulmonary disease who developed P multocida pneumonia and bacteremia has been described. The infection was treated with antibiotics, and the patient recovered. Pasteurella multocida is known to infect many species of animals. The instances of human infection due to this organ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197709000-00035
更新日期:1977-09-01 00:00:00
abstract::Morbid obesity and type II diabetes, common complications of Prader-Willi syndrome (PWS), are difficult to manage in the home setting. We assessed the effect of specialized group home placement on these complications in eight individuals with PWS, all of whom were obese and four of whom had type II diabetes. The group...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:
更新日期:1995-02-01 00:00:00
abstract::Although successful transposition of the ovaries at the time of staging laparotomy for Hodgkin's disease is well documented, little comment has been made on potential complications. This case report of a primary ovarian neoplasm (benign) developing in a transposed ovary serves to alert physicians as to possible ovaria...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198307000-00039
更新日期:1983-07-01 00:00:00