Southern medical journal
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Southern medical journal · May 2022
Multidrug-Resistant Bloodstream Infections in Internal Medicine: Results from a Single-Center Study.
Infections due to multidrug-resistant organisms (MDROs) are expanding globally and are associated with higher mortality rates and hospital-related costs. The objectives of this study were to analyze the trends of MDRO bacteremia and antimicrobial resistance rates in Internal Medicine wards of our hospital and to identify the variables associated with these infections. ⋯ Our analysis reveals a concerning microbiological situation in an Internal Medicine setting, in line with other national and regional data. The risk variables for infection by MDRO identified in our study correspond to those reported in the literature, although studies focused on Internal Medicine settings appear to be limited.
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Southern medical journal · May 2022
Annual FEV1 Loss in Patients with Noncystic Fibrosis Bronchiectasis and Affecting Factors.
Bronchiectasis is a chronic respiratory disease characterized by sputum production, cough, and several bronchial infections. Lung function is an important parameter to evaluate and study in patients with bronchiectasis. This study aimed to evaluate the annual changes in forced expiratory volume in one second (FEV1) and related factors in patients with with noncystic fibrosis bronchiectasis. ⋯ An annual mean FEV1 loss of 39 mL was found in adult patients with noncystic fibrosis bronchiectasis. The annual mean FEV1 decline was found to be associated with the baseline FEV1 value. Physicians should exercise caution in this regard in patients with bronchiectasis with low FEV1 values.
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Southern medical journal · May 2022
Developing Awareness and Allies: Simulating Difficult Conversations about Microaggressions for Faculty and Students.
Discrimination and bias in clinical training often take the form of microaggressions, which, albeit unintentional, are detrimental to the learning environment and well-being of students. Although there are a few reports of medical schools training students to respond to microaggressions, none have included a complementery student-led faculty training module. The aim of this study was to develop and evaluate a case-based approach to improving student resilience and increasing faculty awareness of microaggressions in the clinical setting. ⋯ This approach had results similar to other studies, with the additional benefit of training faculty with the same scenarios. We believe that this method helped bridge the gap between students' notions of discrimination and faculty understanding of microaggressions.
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Southern medical journal · May 2022
Optimizing the Educational Value of Bedside Rounds by Exploring Perceptions of Internal Medicine Residents.
Bedside rounds provide a valuable opportunity for residents to learn vital clinical skills, yet they are increasingly being replaced by card-flip rounds in conference rooms. Residents express mixed views about the educational value of bedside rounds; however, little is known about their perspectives regarding how the structure and content of bedside rounds can be optimized for their learning. We sought to explore residents' attitudes toward bedside rounds and perceptions regarding how to maximize their educational value. ⋯ Residents outlined institutional factors that should be addressed and three high-yield content areas for faculty development programs: rounding structures, faculty behaviors, and bedside educational content. These findings helped us develop guidelines and faculty development sessions for attendings engaging in bedside rounds.
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Thyroidectomies involve meticulous dissection of a highly vascularized organ and complications may develop, such as hematoma, hypocalcemia, and even hypoparathyroidism. Because some of these complications may be fatal, we sought to identify the differences in postthyroidectomy outcomes when the use of a vessel sealant device (VSD) such, as LigaSure or Harmonic scalpel, is compared with more traditional techniques, such as ligatures and clips. ⋯ Analysis of the American College of Surgeons National Surgical Quality Improvement Program data indicates that VSDs are associated with a lower risk of complications, such as hypocalcemia, hematoma, and deep vein thrombosis, suggesting that VSDs may be a more effective method of hemostasis than traditional techniques.