Abstract:
OBJECTIVE:To perform a needs assessment to determine the extent to which hospitalist providers recognize and intervene upon obese patients in the hospital setting. METHODS:A chart review was performed for patients admitted to the hospitalist service at Johns Hopkins Bayview Medical Center between September 1 and October 1, 2008. Patient charts were reviewed for documentation of obesity and treatment plans were ordered and implemented. Demographic data for patients and hospitalist providers was also collected. Providers were also surveyed about their documentation practices related to obesity and any perceived barriers. RESULTS:Forty-nine percent (136/276) of admitted patients were obese. Obesity was documented in 19% (26/136) of admission notes and a discrete plan was made to address obesity 7% (10/136) of the time. Hospitalist providers were more likely to document obesity in patients <60 years old (85% versus 55% respectively, P <0.007), and in patients with body mass indices (BMI) >or= 35 (77% versus 44% respectively, P < 0.004). Provider survey results suggest that providers do not document obesity because it is not considered to be an acute issue (67%), and they elect not to address obesity because they lack the time (63%), skill (37%), and they believe that their efforts will be unsuccessful (33%). CONCLUSION:Documentation of obesity by hospitalist providers is poor. Because an inpatient admission has been characterized as a teachable moment when patients are willing to reflect on behavior change, this may be an ideal time to counsel and educate obese patients.
journal_name
South Med Jjournal_title
Southern medical journalauthors
Howe EE,Wright SM,Landis R,Kisuule Fdoi
10.1097/SMJ.0b013e3181dfd715subject
Has Abstractpub_date
2010-06-01 00:00:00pages
500-4issue
6eissn
0038-4348issn
1541-8243pii
00007611-201006000-00006journal_volume
103pub_type
杂志文章abstract::To assess the reliability and accuracy of the Papanicolaou smear for the detection of cervical Chlamydia trachomatis infections, we obtained chlamydial cultures and cervical smears from 252 patients attending a gynecologic service during an eight-month time period. In 12 of these patients (4.8%), the cervical culture ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:
更新日期:1985-11-01 00:00:00
abstract:OBJECTIVES:This study describes the clinical problems and psychiatric diagnoses of college students who sought services at a student counseling clinic and were subsequently referred for evaluation by a psychiatrist. Several important psychiatric problems present before leaving for college that could mandate the selecti...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.14423/SMJ.0000000000001089
更新日期:2020-05-01 00:00:00
abstract::Subacute bacterial endocarditis in a 72-year-old woman was found to be caused by nutritionally deficient ("satelliting") Streptococcus sanguis. The organism, which required pyridoxal compounds or thiol substitutes, was identified after the application of relatively unusual but simple laboratory procedures. Normally, t...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:
更新日期:1980-12-01 00:00:00
abstract:OBJECTIVES:Non-small-cell lung cancer (NSCLC) patient survival depends on a number of factors, including early diagnosis and initiation of treatment. Standard treatment options for patients with NSCLC include surgery, radiation therapy, and chemotherapy. The objective of this study was to evaluate the impact that the i...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.14423/SMJ.0000000000000601
更新日期:2017-02-01 00:00:00
abstract::A controlled trial of treatment of chronic osteomyelitis caused by Staphylococcus aureus compared nafcillin alone with nafcillin plus rifampin for a six-week period. Treatment was well tolerated, the only adverse effect being mild neutropenia in four of 18 patients; no toxicity was observed from rifampin. Eight of ten...
journal_title:Southern medical journal
pub_type: 临床试验,杂志文章
doi:10.1097/00007611-198608000-00008
更新日期:1986-08-01 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::When involuntary psychiatric patients are treated on unlocked units, problems may arise as to resource expenditure and the ability to provide optimal psychiatric care. This study investigates the problem and possible solutions. ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199306000-00016
更新日期:1993-06-01 00:00:00
abstract::In three patients with SIADH, mannitol or glycerol promoted a rapid free water diuresis. Use of osmotic agents requires less laboratory and clinical monitoring than use of furosemide, is appropriate treatment, and in fact may be the treatment of choice in some patients with symptomatic hyponatremia from SIADH. ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198503000-00028
更新日期:1985-03-01 00:00:00
abstract:OBJECTIVES:The need for colonoscopy is common among diabetic patients. However, there are no standards per se for bowel preparation in patients with type 2 diabetes. In this study, we evaluated the efficacy, safety, and tolerability of sodium phosphate (NaP), and the quality of bowel cleansing in relation to glycemic c...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/SMJ.0b013e3181f20b13
更新日期:2010-11-01 00:00:00
abstract::A 68-year-old male presented with progressive abdominal pain, dyspnea, weight loss, and dysuria. Lab work revealed elevated creatine phosphokinase levels, prostate-specific antigen level (approximately 60 ng/mL), and elevated liver enzymes. He was admitted to the intensive care unit for worsening respiratory distress ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/SMJ.0b013e31817c74c3
更新日期:2008-10-01 00:00:00
abstract::Payment systems in the US healthcare system have rewarded physicians for services and attempted to control healthcare spending, with rewards and penalties based upon projected goals for future spending. The incorporation of quality goals and alternatives to fee-for-service was introduced to replace the previous system...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.14423/SMJ.0000000000000626
更新日期:2017-04-01 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 prospectively studied preoperative and postoperative grip and pinch strength in 21 patients having 30 consecutive median nerve decompressions for carpal tunnel syndrome. All procedures were done by one surgeon. Each hand operated on served as its own control and was studied by the same therapist preoperatively and ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199209000-00009
更新日期:1992-09-01 00:00:00
abstract::From Jan 1, 1978 through Dec 31, 1983, 64 patients with epithelial ovarian tumors, frankly malignant or borderline, were managed at one institution. Nineteen patients (29.7%) were under age 40. The youngest patient was 19 years old. Nulliparity was present in 32% of this group of patients. Of these young patients, 58%...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198801000-00003
更新日期:1988-01-01 00:00:00
abstract::From January 1979 to October 1986, 86 patients with surgically resectable adenocarcinoma of the rectum or rectosigmoid were treated with adjuvant radiotherapy consisting of preoperative 2,400 cGy (22 patients), preoperative 4,000 cGy (14 patients), "sandwich" technique (27 patients), and postoperative irradiation (23 ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199007000-00014
更新日期:1990-07-01 00:00:00
abstract:BACKGROUND:Smokeless tobacco (ST) use is associated with significant health risks and is increasing in prevalence in the United States. This study examined the prevalence of ST use among patients seen in two family practice centers and the documentation of that ST use in the medical record. METHODS:A survey of 209 pat...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199712000-00012
更新日期:1997-12-01 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::Nonspherocytic hemolytic anemia was diagnosed in a 34-year-old man with jaundice since childhood. Splenectomy at the age of 8 had no influence on the anemia. Bronze diabetes was diagnosed at age 31, presumably due to hemosiderosis and secondary hemochromatosis. Iron chelation was unsuccessful in controlling iron overl...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198505000-00027
更新日期:1985-05-01 00:00:00
abstract:OBJECTIVES:Current US healthcare delivery systems do not adequately address healthcare demands. Physicians are integral but rarely emphasize prevention as a primary tool to change health outcomes. Home visitation is an effective method for changing health outcomes in some populations. The Florida International Universi...
journal_title:Southern medical journal
pub_type: 杂志文章,随机对照试验
doi:10.1097/SMJ.0000000000000080
更新日期:2014-04-01 00:00:00
abstract::A retrospective review of all admissions to the University of Kentucky Medical Center from 1977 to 1987 revealed six persons in whom splenic vein thrombosis could be documented. The patients had either upper gastrointestinal bleeding from gastroesophageal varices or abdominal pain. Pancreatic disease was present in fi...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/00007611-199004000-00014
更新日期:1990-04-01 00:00:00
abstract::Coronary artery spasm can occur in the presence of excessive alpha-adrenergic tone. A decrease in protective coronary vasodilator substance and enhanced alpha-adrenergic responsiveness, which occurs in the setting of hypothroidism and beta blockade, predisposes to coronary artery spasm. The case presented supports the...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197907000-00004
更新日期:1979-07-01 00:00:00
abstract:BACKGROUND:The use of lasers has assumed an increasingly important role in the treatment of a variety of cutaneous lesions over the past few decades. Because of their effectiveness, physicians from a variety of specialties have incorporated lasers into their practices. Unfortunately, widespread availability of lasers a...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/00007611-199809000-00002
更新日期:1998-09-01 00:00:00
abstract::We have described a case in which the diagnosis of multiple sclerosis with findings of progressive paraplegia and a neurogenic bladder led to supravesical urinary diversion. Pyocystis led to creation of a urethrovesicovaginal fistula. Psychotherapy later uncovered hysterical conversion reaction. Which was cured with h...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198109000-00039
更新日期:1981-09-01 00:00:00
abstract::Because household surveys are expensive and time consuming, determination of state or local family planning needs is based on national household survey estimates of contraceptive use rather than state-specific estimates. In June 1982, the University of Georgia Survey Research Center invited the Georgia Department of H...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198503000-00022
更新日期:1985-03-01 00:00:00
abstract::Axillary and palmar hyperhidrosis are featured prominently in the literature, but no previous studies have detailed a treatment regimen for specific excessive localized sweating of the face and scalp. In this report, a patient was treated for this condition with a combination of clonidine hydrochloride (0.3 mg to 0.4 ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:
更新日期:2000-01-01 00:00:00
abstract::Concurrent occurrence of carotid artery stenosis and intracerebral aneurysm is uncommon and poses a therapeutic dilemma. We report a patient with bilateral carotid artery stenosis and a 2.5 cm left middle cerebral artery aneurysm who simultaneously underwent a successful stent-assisted coiling for his intracerebral an...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/01.smj.0000217190.93989.c9
更新日期:2006-07-01 00:00:00
abstract::The 15th case of maternal death associated with sepsis in pregnancy in a patient using the Dalkon Shield intrauterine device is reported. Intrauterine sepsis appears to be a complication of the use of this device. B acteria enter the uterus during pregnancy through the multifilament tail of the device. The management ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197702000-00042
更新日期:1977-02-01 00:00:00
abstract::A 36-year-old man was found to have severe pulmonary hypertension and a right-to-left shunt secondary to a patent ductus arteriosus. Attempt at surgical closure was unsuccessful. The patient was followed up for 21 years, and his only significant medical problem is leg weakness to moderate exertion. ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198005000-00036
更新日期:1980-05-01 00:00:00
abstract::Patients with sickle cell disease are predisposed to infection caused by Streptococcus pneumoniae. However, there has been only one published case of bacteremic pneumococcal meningitis in an adult with sickle cell anemia. We report here the cases of six adults with sickle cell disease, pneumococcal sepsis, and meningi...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199009000-00005
更新日期:1990-09-01 00:00:00
abstract::We studied the efficacy of infrainguinal bypass for limb salvage in patients with end-stage renal disease. The patency of 42 femoropopliteal and femorodistal bypasses, performed for limb salvage in 37 patients with end-stage renal disease, was assessed with Doppler ultrasonography and dye tests. Patency rates and limb...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199102000-00009
更新日期:1991-02-01 00:00:00