Southern medical journal
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Southern medical journal · Jun 2016
Making of a Successful Early Mobilization Program for a Medical Intensive Care Unit.
To provide a guideline for intensive care unit (ICU) early mobilization program development and implementation and to describe the patient characteristics and endpoints for those who participated in our hospital's early mobilization program. ⋯ Addressing analgesia and sedation practices, along with instituting a progressive mobility protocol and recruiting physical and occupational therapy, may serve as a guide to the creation of a successful early mobilization program. This study provides additional supportive evidence that early mobilization in the ICU is safe and effective.
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Southern medical journal · Jun 2016
Predictor of 90-Day Readmission Rate for Hepatic Encephalopathy.
The purpose of our study was to identify clinical parameters associated with readmissions within 90 days in patients with hepatic encephalopathy (HE). ⋯ Our study demonstrates that hypertension increased the risk of readmission in patients with HE. More intensive interventions in these patients may decrease readmission rates and improve outcomes.
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Southern medical journal · May 2016
Prospective Evaluation of the Clinical Features of Choledocholithiasis: Focus on Abdominal Pain.
Although abdominal pain is a cardinal feature of choledocholithiasis, there has been little formal study of the features of pain in this condition. The objective of this study was to prospectively evaluate the clinical, laboratory, and radiological features of common bile duct stones, focusing on the characteristics of abdominal pain. ⋯ In our study, choledocholithiasis had a characteristic pattern of constant epigastric pain radiating to the back that was associated with nausea. A prior episode was common. The most common laboratory abnormality was transaminase elevation, and the most common imaging finding was common bile duct dilatation.
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Southern medical journal · May 2016
Comparative StudyComparison of Adenoma Detection Rates in Afro-Caribbeans and Non-Hispanic Whites Undergoing First Screening Colonoscopy.
The African American population has a higher prevalence of advanced colon adenomas when compared with non-Hispanic whites and Hispanics, but the risk in other black populations has not been evaluated. Although the Afro-Caribbean population is a significant demographic segment in some regions of the United States, the data are limited on the prevalence of colon adenomas in this group and there is no comparison with a non-Hispanic white population. The objective of our study was to compare the prevalence of adenomas in Afro-Caribbean versus non-Hispanic white populations. ⋯ We found a similar adenoma detection rate and advanced adenoma prevalence among Afro-Caribbeans and non-Hispanic whites undergoing their first screening colonoscopy. As such, the Afro-Caribbean population may not have the same risk of colorectal neoplasia as what has been described for African Americans. Based on these results, it is appropriate to initiate colorectal cancer screening for Afro-Caribbeans at age 50 as recommended for non-Hispanic whites.
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Smoking rates are two to three times higher among people living with HIV and AIDS compared with the general population, but the prevalence of tobacco use among this population in the Charleston, SC region has not been established. To understand cigarette use, previous quit attempts, historic use of cessation therapies, and interest in cessation, a quality improvement project was implemented to survey smoking behaviors among this population. ⋯ This study supports that high rates of smoking exist in the south among people living with HIV and AIDS and demonstrated a need for smoking cessation interventions among these patients. These data have potentiated the hiring of a clinical pharmacist to aid in implementation of smoking cessation therapies in a more systematic and formal way.