Southern medical journal
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Southern medical journal · Dec 2021
Clinical Outcomes of Noninvasive Ventilation in Asthma, Bronchiectasis, and Other COPD.
Chronic obstructive pulmonary disease (COPD) is a leading cause of mortality and disability worldwide. Use of noninvasive ventilation (NIV) appears to be associated with a significant decrease in frequency of exacerbation, hospital admissions, and mortality in patients with COPD. In this study, we sought to determine clinical outcomes, prevalence, patient profiles and systems characteristics associated with the use of NIV in patients with asthma, bronchiectasis, and other COPD. ⋯ Inpatient use of NIV has a clear mortality benefit in asthma, bronchiectasis, and COPD. These findings support a signal for potential benefit, particularly among certain populations and warrant further investigation.
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Southern medical journal · Dec 2021
Observational StudyPrevalence of Planned Abdominal Binder Use after Vaginal Delivery.
Pregnancy and vaginal delivery are risk factors for pelvic floor dysfunction. Abdominal binder use may increase intraabdominal pressure, affecting pelvic floor healing or function in recently traumatized postpartum pelvic floor muscle. This study assesses the prevalence of postpartum abdominal binder use, timing, and reasons for use. ⋯ Among women delivering at our institution, planned abdominal binder use postvaginal delivery is common. The reasons cited include health and desire to return to prior body shape. The effects of using an abdominal binder in the postpartum period are unknown. More research is needed to better elucidate how increased postpartum intraabdominal pressure affects healing in traumatized pelvic floor muscles.
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To determine whether scores obtained from Patient Health Questionnaire-9 (PHQ-9) or the General Anxiety Disorder-7 (GAD-7) instruments administered following a concussion can be used to predict recovery time. ⋯ Scores obtained from PHQ-9 and GAD-7 screening tools appear to be predictive of an individual's recovery and may help identify those subjects who may benefit from early psychological interventions.
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Southern medical journal · Dec 2021
A High-Value Care Curriculum Using Individual and Group Structured Reflection.
One-third of all healthcare dollars are wasted, primarily in the form of clinician-ordered unnecessary diagnostic tests and treatments. Medical education has likely played a central role in the creation and perpetuation of this problem. We aimed to create a curriculum for medical students to promote their contribution to high-value care conversations in the clinical environment. ⋯ When provided appropriate resources, medical students are able to identify relevant examples of low-value care, downstream solutions, and barriers to implementation through a structured reflection curriculum comprising written narratives and in-person debate.