Bouveret Syndrome: A Rare Form of Gallstone Ileus.

Bouveret's syndrome is a rare variant of gallstone ileus characterized by a gastric outlet obstruction due to the impaction of a gallstone lodged in the duodenum, resulting from a cholecystoduodenal fistula. It accounts for only one to three percent of cases of gallstone ileus. We examine a case of Bouveret syndrome in an elderly Japanese female who presented with vomiting and decreased oral intake.

Electronic health records and support for primary care teamwork.

Objective: Consensus that enhanced teamwork is necessary for efficient and effective primary care delivery is growing. We sought to identify how electronic health records (EHRs) facilitate and pose challenges to primary care teams as well as how practices are overcoming these challenges.

Methods: Practices in this qualitative study were selected from those recognized as patient-centered medical homes via the National Committee for Quality Assurance 2011 tool, which included a section on practice teamwork.

Overcoming challenges to teamwork in patient-centered medical homes: a qualitative study.

Background: There is emerging consensus that enhanced inter-professional teamwork is necessary for the effective and efficient delivery of primary care, but there is less practical information specific to primary care available to guide practices on how to better work as teams.

Objective: The purpose of this study was to describe how primary care practices have overcome challenges to providing team-based primary care and the implications for care delivery and policy.

Approach: Practices for this qualitative study were selected from those recognized as patient-centered medical homes (PCMHs) via the most recent National Committee for Quality Assurance PCMH tool, which included a domain on practice teamwork.

Effectiveness of using a mat filled with a peroxygen disinfectant to minimize shoe sole contamination in a veterinary hospital.

Objective: To determine the effectiveness of using a disinfectant mat filled with a peroxygen compound to prevent mechanical transmission of bacteria via contaminated footwear between the food animal ward and common breezeway of a veterinary teaching hospital.

Design: Observational study.

Sample Population: Shoe soles of individuals entering and exiting from the ward.