Abstract:
:In response to the increasing care needs of geriatric patients and attendant hospital costs, the Nashville Veterans Administration Medical Center, which has 393 beds and admits 8400 patients annually, initiated an Intermediate Care Service in 1988. A geriatric team was formed, sharing staff and resources from existing units. To determine the efficacy of intermediate care, automated data sources at the Nashville Veterans Administration Medical Center provided data on discharge status, length of stay, and diagnoses of patients in both the acute and intermediate care units. The first year's experience indicated that careful communication and education of nursing staff was required to initiate the Intermediate Care Service with no staff resigning. An interdisciplinary team facilitated better patient care and discharge planning. Among 190 patients discharged from this service, 57% were discharged home and 22% into nursing homes; this can be compared to those discharged from acute care units of the hospital: 84% home and 4% to a nursing home; 20% of the patients in the Intermediate Care Service were discharged to a lower level of care than the initial hospital discharge plan had indicated. A 1.4-day decrease in average length of stay in the hospital has occurred since initiation of the Intermediate Care Service.
journal_name
South Med Jjournal_title
Southern medical journalauthors
Hauser B,Robinson J,Powers JS,Laubacher MAsubject
Has Abstractpub_date
1991-05-01 00:00:00pages
597-602issue
5eissn
0038-4348issn
1541-8243journal_volume
84pub_type
杂志文章abstract::In this paper we describe a technique for continuous spinal anesthesia, first described at the turn of the 20th century and long thought to have become obsolete. We discuss reasons for discontinuance and neglect of the technique, as well as its indications, applications, and specific advantages, and we report a signif...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198802000-00008
更新日期:1988-02-01 00:00:00
abstract::The rapid increase in the use of helicopters for hospital transport during the 1980s is the culmination of several hundred years of military medical innovation. Mass battefield casualties spurred both technologic and medical changes necessary for today's sophisticated helicopter systems in use worldwide, particularly ...
journal_title:Southern medical journal
pub_type: 历史文章,杂志文章
doi:10.1097/00007611-198907000-00022
更新日期:1989-07-01 00:00:00
abstract::A 16-year-old white boy had nephrotic syndrome due to focal segmental glomerulosclerosis six months before the diagnosis of Hodgkin's disease was established. Peritoneal dialysis was necessary for volume control after one month of unsuccessful therapy with high doses of corticosteroids. Nephrosis remitted after two co...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198909000-00034
更新日期:1989-09-01 00:00:00
abstract::We have presented the case of a 32-year-old man who sustained blunt trauma to the chest in a motor vehicle accident. Plain roentgenograms showed a widened mediastinum and pneumomediastinum, and an esophagogram with water-soluble contrast material showed an esophageal laceration at the T-4 level. ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:
更新日期:1991-06-01 00:00:00
abstract::Mycobacterium fortuitum is a rare, opportunistic pathogen most frequently contracted through contact with a contaminated source. An immunocompetent 26-year-old female patient presented to our institution with an infected lumboperitoneal (LP) shunt presenting as continued nonhealing wounds. After multiple debridements,...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.14423/SMJ.0000000000000955
更新日期:2019-04-01 00:00:00
abstract::Only in relatively recent years has the role of dietary fiber, once thought to be an unnecessary and even undesirable by-product, begun to be appreciated in the maintenance of health. Research now indicates that a deficiency of fiber in the modern western diet may contribute to a host of diseases. Inadequate dietary f...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198610000-00003
更新日期:1986-10-01 00:00:00
abstract:OBJECTIVE:To assess the current use of β-blockers in patients with compelling indications for use, following the acute exacerbation of chronic obstructive pulmonary disease (COPD). METHODS:We performed a multicenter retrospective observational study using data from all of the patients admitted to five institutions for...
journal_title:Southern medical journal
pub_type: 杂志文章,多中心研究
doi:10.14423/SMJ.0000000000001038
更新日期:2019-11-01 00:00:00
abstract::We have reported a case of aplastic crisis occurring in an 11-year-old black boy with occult hereditary spherocytosis. An etiologic diagnosis of human parvovirus (HPV) B19 infection was confirmed serologically. The Coulter Model S + IV proved useful for both diagnosis and treatment monitoring through serial histograms...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198902000-00023
更新日期:1989-02-01 00:00:00
abstract:BACKGROUND:Cancer of the esophagus remains a highly lethal disease, but new treatment approaches that build onto traditional surgical and radiotherapeutic methods are making an impact on organ preservation while offering hope for improved survival. METHODS:Reviewed here are recent data from trials on the use of new ra...
journal_title:Southern medical journal
pub_type: 临床试验,杂志文章,随机对照试验,评审
doi:10.1097/00007611-199911000-00003
更新日期:1999-11-01 00:00:00
abstract::Sepsis due to Pseudomonas aeruginosa continues to be an important source of morbidity and mortality in hospitalized patients. Early recognition of this condition is of paramount importance in choosing specific therapy at the earliest possible moment. We present three cases in which P aeruginosa bacteremia was manifest...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199402000-00017
更新日期:1994-02-01 00:00:00
abstract::The percutaneous subclavian vein hemodialysis catheter, which is widely used for vascular access in patients with renal failure, can give rise to several complications. Asymptomatic stenosis or occlusion of the subclavian vein due to these catheters can lead to painful arm edema if further dialysis accesses are constr...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198803000-00004
更新日期:1988-03-01 00:00:00
abstract::As residency programs adapt to the need to promote primary care, the importance of quantitating qualitative issues increases. In this study, a questionnaire based on reported residency stressors was answered by 238 internal medicine residents. The Profile of Mood States (POMS) was also completed by 64. Factor analysis...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199507000-00010
更新日期:1995-07-01 00:00:00
abstract::Elderly patients with community-acquired pneumonia may not have a systemic inflammatory response characterized by fever and leukocytosis. We compared lack of fever and leukocytosis with mortality in elderly patients with community-acquired pneumonia. Patients with fever and leukocytosis (group A, 47 patients) were com...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199703000-00006
更新日期:1997-03-01 00:00:00
abstract::Hypochlorhydric states such as atrophic gastritis and partial gastrectomy have long been known to cause iron deficiency anemia. However, studies to date have failed to show a similar association with omeprazole, a proton pump inhibitor that also produces achlorhydria. These studies, however, have primarily involved no...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/01.SMJ.0000110405.63179.69
更新日期:2004-09-01 00:00:00
abstract::Pregnancy in patients who have non-Hodgkin's lymphoma is unusual. We have reported a case of diffuse, poorly differentiated lymphocytic lymphoma, stage IIIa, in a patient whose disease went into remission after she received six courses of CHOP therapy (cyclophosphamide, doxorubicin, vincristine, and prednisolone). She...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198510000-00032
更新日期:1985-10-01 00:00:00
abstract::Blastomycosis in children is relatively infrequent. Further, osteomyelitis of the frontal bone, which prior to the antibiotic era occurred more frequently and was mostly due to pyogenic cocci, is rare today. We described a case of frontal osteomyelitis in a child due to blastomycosis which occurred in the absence of f...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197802000-00028
更新日期:1978-02-01 00:00:00
abstract::Coronary heart disease remains the major cause of mortality and morbidity in the United States and other western countries despite major advances in its treatment. During the last decades, many markers of coronary artery disease have been found which help predict future risk of cardiovascular events. High-sensitivity ...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/SMJ.0b013e31816c0195
更新日期:2008-05-01 00:00:00
abstract::Sarcoidosis is a multisystem disorder of unknown cause, characterized pathologically by noncaseating granulomas. It is more commonly seen in younger adults and African Americans. Myocardial involvement occurs in at least 25% of patients with sarcoidosis and is associated with poor prognosis. In spite of recent advance...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/SMJ.0b013e318189570e
更新日期:2008-10-01 00:00:00
abstract::Granular cell tumors (GCT) are rare, usually benign neoplasms of Schwann cell origin. Since discovery in 1926, fewer than 80 cases of GCT involving the lung have been reported. This report presents a 45-year-old male who presented with symptoms consistent with chronic pancreatitis associated with night sweats, weight ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/01.smj.0000182134.44098.01
更新日期:2005-10-01 00:00:00
abstract::Unicompartmental replacement using the Marmor prosthesis was done in 40 knees (37 patients) with medial compartment gonarthrosis. Of the 27 available for follow-up, results were considered excellent in 18 cases and good in seven, while two cases were considered failures. Meticulous removal of osteophytes by intercondy...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197906000-00013
更新日期:1979-06-01 00:00:00
abstract::In this series, thorough evaluation of 250 mediastinal lesions by various diagnostic methods showed that contrast enhanced CT scans of the mediastinum were superior to other modalities in differentiation and precise localization of the various types of lesions. Such superior evaluation may have a profound effect on th...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198504000-00009
更新日期:1985-04-01 00:00:00
abstract::Malacoplakia is a granulomatous disease of unknown cause often associated with a coliform urinary infection. It is occasionally a self-limiting disease with diverse clinical presentations and roentgenographic appearances. The importance of a differential diagnosis which considers malignancy is emphasized. A rare insta...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197703000-00029
更新日期:1977-03-01 00:00:00
abstract::We describe a rare occurrence of comorbidity of schizophreniform disorder and borderline personality disorder as an initial patient presentation. ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199803000-00013
更新日期:1998-03-01 00:00:00
abstract::Three patients seen recently at Wilford Hall USAF Medical Center emphasize the point that coccidioidomycosis may resemble lymphoma because of persistence of adenopathy on the chest roentgenogram after the initial infiltrate has resolved. Such a clinical picture strongly indicates dissemination and is probably sufficie...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197705000-00007
更新日期:1977-05-01 00:00:00
abstract::Superior mesenteric artery (SMA) syndrome is an atypical cause of high intestinal obstruction, most frequently occurring in patients who have had rapid weight loss. Identification of this syndrome can be a diagnostic dilemma and is frequently made by exclusion. The most characteristic symptoms are postprandial epigast...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:
更新日期:2000-06-01 00:00:00
abstract::Thirty-four cases of meningococcal disease were identified in a retrospective survey of nine US Army posts in the southeastern United States from June 1977 to August 1979. Group B organisms predominated in dependents and civilian communities surrounding two of the posts, while active-duty personnel had a greater varie...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198102000-00007
更新日期:1981-02-01 00:00:00
abstract::Presented in a case in which calcification of the adrenal gland was roentgenographically evident on the first day of life. The earliest previously reported case of adrenal calcification was at 8 days of age and was attributed to an intrapartum hemorrhage. It is proposed that an intrauterine third trimester insult was ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197903000-00045
更新日期:1979-03-01 00:00:00
abstract::All cases of surgically proven and cured primary hyperparathyroidism, over a five-year period, were reviewed for the presence of hypertension, renal and/or prerenal azotemia, nephrolithiasis, nephrocalcinosis, and patient symptom status. In this group of 23 patients, the prevalence of hypertension was greater than 78%...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198211000-00018
更新日期:1982-11-01 00:00:00
abstract::Most patients with heart failure today are treated by primary care practitioners, not cardiologists. The Consensus Recommendations for the Management of Chronic Heart Failure, developed by the Advisory Council to Improve Outcomes Nationwide in Heart Failure, provide practice guidelines for the prevention, diagnosis, a...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:
更新日期:2001-02-01 00:00:00
abstract::Elevation in fasting serum gastrin levels was found in three patients being evaluated for persistent upper abdominal pain without radiographic evidence of peptic ulcer disease. Fiberoptic endoscopy of the upper gastrointestinal tract in each patient revealed characteristic changes of chronic atrophic gastritis. Gastri...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197612000-00010
更新日期:1976-12-01 00:00:00