Publications by authors named "James A Welker"
Background: The study's main aim was to determine the prevalence of elevated D-dimer levels in adult patients hospitalized for acute medical illnesses not suspected to have venous thromboembolism (VTE). The secondary aims were to determine VTE prophylaxis rates and VTE events.
Methods: This multicenter, prospective, observational study included patients who were admitted across nine US hospitals.
Article Synopsis
- Traumatic spinal cord injury patients, particularly those with quadriplegia from Neuromyelitis Optica, face a significant risk of developing pneumonia, a topic that hasn't been thoroughly researched.
- A case study highlights a patient who, due to recurring respiratory infections and lengthy hospital stays, benefited from using CPAP therapy at night, which effectively reduced infections and hospital duration.
- It's noted that Neuromyelitis Optica patients require ongoing monitoring and management strategies, like CPAP, to prevent pneumonia and related complications, given their different health challenges compared to those with traditional traumatic spinal cord injuries.
Background: Many hospitalized Medical Service patients are at risk for venous thromboembolism in the months after discharge. We conducted a multicenter randomized controlled trial to test whether a hospital staff member's thromboprophylaxis alert to an Attending Physician before discharge will increase the rate of extended out-of-hospital prophylaxis and, in turn, reduce the incidence of symptomatic venous thromboembolism at 90 days.
Methods: From April 2009 to January 2010, we enrolled hospitalized Medical Service patients using the point score system developed by Kucher et al to identify those at high risk for venous thromboembolism who were not ordered to receive thromboprophylaxis after discharge.
Objective: Clostridium difficile-associated disease (CDAD) is common and has a 6.1% mortality. Governmental agencies have recommended surveillance, but reporting increases health care costs.
View Article and Find Full Text PDFArticle Synopsis
- The study examined the impact of reducing the time to first antibiotic dose (TFAD) for pneumonia patients from 8 hours to under 4 hours on the diagnosis accuracy by emergency department (ED) physicians.
- Results showed that patients in the 4-hour TFAD group were significantly less likely to meet the diagnostic criteria for community-acquired pneumonia (CAP).
- The conclusion suggests that while the time pressure to administer antibiotics was tightened, it did not improve the TFAD and may have negatively impacted the accuracy of pneumonia diagnoses.
Implementation of electronic data capture systems: barriers and solutions.
Contemp Clin Trials
May 2007
Although increasing in pace, the conversion to Electronic Data Capture (EDC) has been a slow progression. The use of EDC systems should confer improved data integrity, cost savings and a shorter time to study database closure. This will reduce the time to market and cost of new medications.
View Article and Find Full Text PDFThe distinction between authorship and other forms of credit for contribution to a publication has been a persisting controversy that has resulted in numerous guidelines outlining the expected contributions of those claiming authorship. While there have been flagrant, well-publicized deviations from widely accepted standards, they are largely outnumbered by cases that are not publicity-worthy, and therefore remain known to only those directly involved with the inappropriate conduct. We discuss the definition and ethical requirements of authorship, offer a case example of the authorship debate created by a technical tool at our institution, and review parallels that support and dispute the authorship claims of our software developers.
View Article and Find Full Text PDFBackground: Sixty percent of removed solitary pulmonary nodules (SPNs) are benign. An approach that reduces the unnecessary excision of benign nodules is consistent with the oncologic objective of organ preservation.
Methods: A prospective observational study was performed at a lung cancer referral center in which consecutive patients were evaluated who presented with SPNs measuring < 4 cm on computed tomography (CT) scans.
Cryofibrinogenemia is a rarely symptomatic disorder that is underrecognized due to the infrequency with which it causes symptoms. Although completely reversible, this disorder can be life threatening when untreated. In this review, the classification, pathophysiology, and clinical presentation of cryofibrinogenemia are described, based on case reports and prospective observational data.
View Article and Find Full Text PDFPurpose: To determine the diagnostic accuracy of image-guided percutaneous biopsy in 110 primary bone tumors of varying internal compositions.
Materials And Methods: One hundred ten consecutive patients with primary bone tumors underwent biopsy with computed tomography (CT) or fluoroscopy. Ninety-one patients underwent surgical follow-up and 19 received medical treatment and underwent subsequent imaging studies.