Abstract:
OBJECTIVES:Transcranial Doppler ultrasound (TCD) effectively identifies children with sickle cell anemia (SCA) who are at increased risk of stroke. We evaluated a low-cost quality improvement (QI) intervention to increase the proportion of children screened by TCD. METHODS:We measured the proportion of children with SCA receiving appropriate TCD screening for increased cerebral blood velocity, a marker of stroke risk, for time periods before (April 1, 2009-July 1, 2010) and after (October 1, 2010-January 1, 2012) the implementation of a QI program. We sent eligible families personalized reminder letters, information on screening, and a refrigerator magnet imprinted with the recommended date of TCD screening. RESULTS:Only 54% (60/112) of children (median age 8 years, range 2.2-16.7 years) had a TCD in the baseline period compared with 79% (87/110; P = 0.0001) after implementation of the QI initiative. The odds of appropriate TCD screening decreased with older age in the baseline period (odds ratio 0.86, 95% confidence interval 0.78-0.94/year; P = 0.001), but not after implementation. Neither predicted travel time by car (median 20 minutes, range 2-164) nor distance traveled (median 9.7 mi, range 0.4-132) was significantly associated with appropriate TCD screening before or after QI implementation. The number needed to treat was four. CONCLUSIONS:We demonstrated the feasibility and effectiveness of a low-cost QI intervention to increase TCD screening. This approach was more successful than other related intervention models and is easily implemented by smaller sickle cell programs without full-time personnel.
journal_name
South Med Jjournal_title
Southern medical journalauthors
Muntz DS,Bundy DG,Strouse JJdoi
10.14423/SMJ.0000000000000517subject
Has Abstractpub_date
2016-09-01 00:00:00pages
506-10issue
9eissn
0038-4348issn
1541-8243pii
SMJ50244journal_volume
109pub_type
临床试验,杂志文章abstract::Of ten patients with anterior diaphragmatic hernia treated by operation, only three had shortness of breath and chest pain. The remainder of the patients were referred to us because of a roentgenographic abnormality. All patients have had follow-up of between six months and 11 years without recurrence. Surgical repair...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198203000-00008
更新日期:1982-03-01 00:00:00
abstract::Stroke is a treatable disease. Despite the therapeutic nihilism of the past, the advent of thrombolysis has changed the way stroke is approached. Acute ischemic stroke is a challenging and heterogeneous disease. Treatment needs to be based on an understanding of the underlying pathophysiology of ischemia. Intervention...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/01.SMJ.0000063573.56033.A6
更新日期:2003-04-01 00:00:00
abstract::This is a systematic review of the available literature and our own personal experience regarding the optimal management of the rhinoplasty patient. The routine utilization of nasal splinting, casting and perioperative antibiotics is supported. The management of a number of common early complications is also discussed...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/SMJ.0b013e3181807a79
更新日期:2008-09-01 00:00:00
abstract::Family physicians and other medical care providers are beginning to realize the importance of a comprehensive assessment examination for elderly patients. The components of such an examination are well documented, and include not only the standard history and physical examination, but also evaluation of mental health,...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199108000-00005
更新日期:1991-08-01 00:00:00
abstract:BACKGROUND:The nursing home clinician may encounter euthyroid residents with low total serum thyroxine (T4) values associated with certain medications or nonthyroidal illness (NTI). Hypothyroidism may be incorrectly diagnosed and thyroid hormone prescribed. METHODS:We reviewed all T4 determinations and individuals wit...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199805000-00005
更新日期:1998-05-01 00:00:00
abstract::Medical inpatients in inner-city hospitals have both potentially lead-related disorders and potential lead exposure. To see whether there is substantial unexpected lead intoxication in this population, we did a cross-sectional study of 117 consecutively admitted patients to a general medical ward of an inner-city univ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199605000-00003
更新日期:1996-05-01 00:00:00
abstract::We present this case to emphasize the potentially fatal outcome of supraventricular tachycardia in infancy, particularly if it has been undiagnosed for several days. Certainly, careful monitoring needs to take place during any attempt at cardioversion or any other noxious stimulation of the patient. Bicarbonate therap...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199401000-00023
更新日期:1994-01-01 00:00:00
abstract::An 86-year-old diabetic man had a late, gas-forming infection about Knowles pins. Although blood cultures were negative, a urinary tract infection followed by infection with the same organism in bone, muscle, and lung strongly supports hematogenous spread of E coli from the genitourinary system in this patient. The ge...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:
更新日期:1983-02-01 00:00:00
abstract::We retrospectively reviewed medical records and computerized critical care data for 40 consecutive critically ill surgical patients receiving "standard" doses (1.5 to 2.0 mg/kg loading dose and 3 to 5 mg/kg/day) of gentamicin or tobramycin for gram-negative infections. End points measured were serum drug levels and cl...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199701000-00007
更新日期:1997-01-01 00:00:00
abstract::A 63-year-old male patient with a history of bipolar I disorder presented to the emergency department in an acutely psychotic state. The patient had just returned from vacation in a malarial high-risk area and, as a result, had taken five weekly doses of mefloquine for prophylaxis. The patient's bipolar disorder was b...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/SMJ.0b013e318167a9e2
更新日期:2008-05-01 00:00:00
abstract::The effect of food on the absorption characteristics of procainamide was assessed after oral administration of the drug to eight male patients in the fasting and postprandial states. Serum concentration-time curves showed no significant difference in peak serum levels of procainamide, in the time the peak value was re...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197607000-00013
更新日期:1976-07-01 00:00:00
abstract:BACKGROUND:: Bronchus-associated Lymphoid Tissue (BALT) lymphomas are a rare type of extranodal marginal zone lymphomas. They comprise 1% of lymphomas and more than two-thirds of all primary non-Hodgkin lymphoma (NHL) of the lung. BALT lymphomas arise from the bronchus-associated lymphoid tissue. METHODS:This report d...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/SMJ.0b013e3181bfdd2d
更新日期:2009-12-01 00:00:00
abstract::A case of perforation and bleeding from a diverticulum of the second portion of the duodenum in a patient with recurrent pancreatitis is presented. Upper gastrointestinal roentgenogram revealed an abnormal tract and retroperitoneal air arising from the diverticulum. The fistulous tract communicated with pancreas. Blee...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197706000-00037
更新日期:1977-06-01 00:00:00
abstract::We discuss the cases of four immigrant workers in whom lead intoxication developed via inhalation while they were cutting steel beams removed from a dismantled bridge. They all had toxic lead levels with symptoms and received chelation therapy; the therapy was followed by a decrease in blood lead levels. Rebound incre...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199407000-00003
更新日期:1994-07-01 00:00:00
abstract:OBJECTIVE:Satiety is the perception of satisfied fullness and represents a summation of neural and hormonal influences. Satiety can be assessed by drink tests, including water load. The objective of our study was to confirm the difference in water load volume between nonobese control children and children with function...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.14423/SMJ.0000000000000612
更新日期:2017-03-01 00:00:00
abstract::Massive unilateral virginal breast hypertrophy in a 13-year-old girl was treated by right breast reduction, with removal of 2,968 g of breast tissue. A year later, the patient had enlargement of the left breast, and contralateral reduction mammoplasty was done. Two-year follow-up has shown no further enlargement. This...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199604000-00019
更新日期:1996-04-01 00:00:00
abstract::Mineral oil scrapings from an infant with a persistent, puzzling, generalized eruption revealed the mite, Sarcoptes scabiei. Various diagnostic technics and treatment for scabies are discussed. ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197505000-00008
更新日期:1975-05-01 00:00:00
abstract::For over a decade there has been concern about hepatitis related to halothane anesthesia. No dose relationship or other direct cause has ever been established, and jaundice has been found to occur after other anesthetics for surgical operations. Enflurane is a newer halogenated compound with a remarkable record of saf...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197807000-00012
更新日期:1978-07-01 00:00:00
abstract:OBJECTIVES:Adherence to National Comprehensive Cancer Network (NCCN) guidelines for ovarian cancer treatment improves patient outcomes. The aim of this study was to assess disparities associated with ovarian cancer treatment in the state of Kentucky and central Appalachia. METHODS:Data on patients diagnosed as having ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.14423/SMJ.0000000000000821
更新日期:2018-06-01 00:00:00
abstract::We compared a "cardiac profile" test with standard creatine kinase (CK) and lactic dehydrogenase (LD) electrophoresis in 798 cases of possible acute myocardial infarction (MI). The cardiac profile enzyme screen (CK-B, CK, LD) used on 495 patients who came to the emergency department with chest pain suggestive of acute...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:
更新日期:1989-09-01 00:00:00
abstract::We measured hemodynamic and respiratory parameters before and after applying methylmethacrylate (MMC) to acetabular and femoral sites during neuroleptanesthesia and prosthetic hip surgery. No significant major changes were documented. Previously reported adverse effects probably have been due to medullary emboli, humo...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198110000-00013
更新日期:1981-10-01 00:00:00
abstract::The vast majority of acute iron toxicity cases occur in children less than 5 years of age. Moreover, clinical hepatic injury is uncommon with most symptoms stemming from the intestinal tract (eg, nausea, vomiting, diarrhea). Therefore, physicians, particularly those who do not routinely treat pediatric patients, are o...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/01.SMJ.0000152546.05519.FE
更新日期:2005-02-01 00:00:00
abstract::To show the usefulness of the Society of Thoracic Surgeons (STS) National Database in providing clinical and cost-related outcome data, we studied 297 consecutive patients who had isolated coronary artery bypass grafting (CABG) and who were assigned to either a "fast track" or traditional track. The observed overall m...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199611000-00009
更新日期:1996-11-01 00:00:00
abstract::We evaluated the indices of arterial distensibility in a group (N = 40) of normotensive subjects and patients with borderline or established hypertension by measuring intra-arterial pressure, pulse wave velocity, and a mathematical modification of MOEN's formula to calculate arterial distensibility. Multiple linear re...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198401000-00015
更新日期:1984-01-01 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:OBJECTIVES:Historically, surgical management of empyema was performed predominantly via open thoracotomy; however, during the past decade the use of video-assisted thoracoscopic surgery (VATS) as an alternative has increased. This study retrospectively compared the outcomes and management of patients with empyema at th...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.14423/SMJ.0000000000000226
更新日期:2015-01-01 00:00:00
abstract:OBJECTIVES:The lack of access to diagnostic imaging in resource-limited settings (RLSs) poses a worldwide problem. Advances in ultrasound (US) imaging technology bridge this gap, particularly when examinations are performed by physicians and integrated into the patient encounter, termed point-of-care ultrasound (POCUS)...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.14423/SMJ.0000000000000826
更新日期:2018-07-01 00:00:00
abstract::We present the case of a 17-year-old girl who came to our center with a red irritated eye from exposure to tarantula hairs. An ophthalmology literature search revealed six reported cases. There have been no reports of these cases in the general medical and pediatric literature. Due to the increasing popularity of tara...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199806000-00011
更新日期:1998-06-01 00:00:00
abstract::Thoracic nerve root dysfunction (TNRD) manifested as abdominal pain is an infrequently reported condition. We present data on six patients who had chronic intermittent thoracoabdominal pain originating in the back. Diabetes and osteoarthritis of the spine were the chief causes of these symptoms. The electromyogram in ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198802000-00014
更新日期:1988-02-01 00:00:00
abstract::Seventeen patients with Crohn's disease requiring emergency operative procedures disclosed important factors leading to successful outcome. In seven of the ten patients not known to have Crohn's disease, the history strongly suggested this diagnosis. Two patients died; three others had major complications, including t...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197810000-00010
更新日期:1978-10-01 00:00:00