Comparison of 3 Surveillance Methods to Detect Potential Controlled Substance Diversion in an Academic Medical Center.

To compare 3 methods of detecting potential diversion of controlled substances (CS) by health care personnel from inpatient units in a large, academic medical center. Three different reports were retrospectively analyzed and evaluated to determine which employees are "high-risk" for diversion over a 30-day period using defined criteria. Reports were derived from automated dispensing machines (ADMs), purchased third-party software (TPS), and the electronic health record (EHR).

Percutane Image-Guided Cryoablation of Painful Osseous Metastases: A Retrospective Single-Center Review.

Purpose: Painful osseous metastases are a common problem in patients with malignancy, and they can be associated with significant morbidity owing to immobility, pain, pathologic fracture, or neurovascular compromise or all of these. We retrospectively evaluated pain levels and tumor enhancement in patients who underwent palliative percutaneous cryoablation for painful bone metastasis.

Methods: In this institutional review board-approved, health insurance portability and accountability act-compliant study, we retrospectively searched our department׳s picture archiving system for patients who underwent computed tomography (CT)-guided percutaneous cryoablation for treatment of painful metastatic osseous disease over a 6-year period (1/1/2005-12/31/2011).

Evolving Pharmacist Productivity Models.

Leaders in health-system pharmacy are challenged to minimize costs, maximize revenue, and maintain or improve quality while simultaneously expanding services. Strong command of productivity and workload measurement is necessary to achieve these goals. This article reviews foundational pharmacy productivity concepts and key terminology, reviews historical pharmacy productivity models and their limitations, and considers new and evolving pharmacist productivity models.

Imaging of the subtalar joint.

Imaging of the subtalar joint can be challenging because of its complex planar anatomy. This article reviews the anatomy and common anatomic variants as seen with different imaging techniques. Although radiography remains the initial mode of imaging, computed tomography and MRI are frequently needed to better delineate the joint anatomy and improve the sensitivity and the specificity of detection of joint pathology.

MRI findings of serous atrophy of bone marrow and associated complications.

Objectives: To report the MRI appearance of serous atrophy of bone marrow (SABM) and analyse clinical findings and complications of SABM.

Methods: A retrospective search of MRI examinations of SABM was performed. Symptoms, underlying conditions, MRI findings, delay in diagnosis and associated complications were recorded.

Development of an inpatient operational pharmacy productivity model.

Purpose: An innovative model for measuring the operational productivity of medication order management in inpatient settings is described.

Methods: Order verification within a computerized prescriber order-entry system was chosen as the pharmacy workload driver. To account for inherent variability in the tasks involved in processing different types of orders, pharmaceutical products were grouped by class, and each class was assigned a time standard, or "medication complexity weight" reflecting the intensity of pharmacist and technician activities (verification of drug indication, verification of appropriate dosing, adverse-event prevention and monitoring, medication preparation, product checking, product delivery, returns processing, nurse/provider education, and problem-order resolution).

The role of pubic symphyseal CT arthrography in the imaging of athletic pubalgia.

Objective: The purpose of this article is to describe the results of pubic symphyseal CT arthrography compared with MRI in patients with suspected athletic pubalgia.

Materials And Methods: In this study, two musculoskeletal radiologists retrospectively searched our department's PACS to identify patients who had undergone CT-guided injection with concurrent pubic symphyseal CT arthrography for evaluation and treatment of groin pain, sports hernia, or athletic pubalgia over a 5.5-year period (January 1, 2007-July 1, 2012).

Isolated fractures of the trapezoid as a sports injury.

The aim of this work is to describe the radiographic findings of isolated trapezoid fractures and determine the utility of these findings in guiding treatment. A second aim is to heighten awareness of an uncommon sports-related injury that is often radiographically occult because of the lack of primary or overt secondary radiographic findings. A retrospective review of radiology reports at our institution from 2007 to 2010 was performed to identify isolated trapezoid fractures.

Association of the presence of bone bars on radiographs and hip fracture in postmenopausal Caucasian women.

Aim: To determine whether the presence of bone bars (BB) identified on anteroposterior hip radiographs are more prevalent in patients that have had a hip fracture as compared to patients without a fracture.

Materials And Methods: Ninety-two Caucasian women with a unilateral proximal femur fracture were retrospectively evaluated and randomly selected using radiology database records to comprise the investigational group. Ninety-eight age-matched Caucasian women without hip fracture were selected as a control group.

Intracranial meningeal hemangiopericytoma metastatic to the scapula.

Meningeal hemangiopericytomas are rare vascular tumors that have a propensity for recurrence and metastasis. Intracranial hemangiopericytomas are rare vascular tumors. They account for 0.

Validation of diagnostic codes for subtrochanteric, diaphyseal, and atypical femoral fractures using administrative claims data.

Administrative claims databases have large samples and high generalizability. They have been used to evaluate associations of atypical femoral fractures with bisphosphonates. We developed and assessed accuracy of claims-based algorithms with hospital and physician diagnosis codes for these fractures.

Assessing rheumatoid arthritis with ultrasound of the hands.

Objective: The purpose of this video article is to show the sonographic techniques and findings in evaluating the joints of the hands in patients with possible inflammatory arthritis and to review the sonographic appearance and grading of synovitis.

Conclusion: This video article shows the value of a targeted approach for musculoskeletal ultrasound of the hand and wrist in patients with rheumatoid arthritis. On completion of this video article, the participant should be able to develop an appropriate diagnostic and therapeutic approach using ultrasound for the treatment of patients with rheumatoid arthritis.

Imaging of nerve entrapment in the foot and ankle.

Neuropathies can be a cause of chronic foot and ankle pain. The diagnosis can be elusive given the sometimes nonspecific clinical presentation. Although electrodiagnostic studies are primarily relied on for the diagnosis of nerve impairment, imaging is sometimes helpful in helping define the exact site of the entrapment and whether any masses are present.

Intramyocellular lipid and insulin resistance: differential relationships in European and African Americans.

Insulin resistance has been associated with the accumulation of fat within skeletal muscle fibers as intramyocellular lipid (IMCL). Here, we have examined in a cross-sectional study the interrelationships among IMCL, insulin sensitivity, and adiposity in European Americans (EAs) and African Americans (AAs). In 43 EA and 43 AA subjects, we measured soleus IMCL content with proton-magnetic resonance spectroscopy, insulin sensitivity with hyperinsulinemic-euglycemic clamp, and body composition with dual-energy X-ray absorptiometry.

Association of the presence of bone bars on radiographs and low bone mineral density.

Objective: Bone bars (BB) are struts of normal trabecular bone that cross the medullary portions of the metaphysis and diaphysis at right angles to the long axis of the shaft. The purpose of this investigation was to determine whether the presence of bone bars (BB) identified on radiographs of the proximal femurs and tibia, predict lower bone mineral density (BMD) as evaluated with dual-energy x-ray absorptiometry (DXA) in the lumbar spine, total hip, or femoral neck.

Materials And Methods: A total of 134 sequential DXA patients underwent radiography of the pelvis, hips, and both knees.

Distribution of Z-scores in a University cohort with an emphasis on "high" bone mineral density.

High bone mineral density (BMD) is currently not defined by the International Society for Clinical Densitometry with a specific Z-score cutoff; however, it has been suggested that a Z-score greater than or equal to 2.5 is not normal. Institutional Review Board approval was obtained.

Pathological fractures of the proximal humerus treated with a proximal humeral locking plate and bone cement.

Bone loss secondary to primary or metastatic lesions of the proximal humerus remains a challenging surgical problem. Options include preservation of the joint with stabilisation using internal fixation or resection of the tumour with prosthetic replacement. Resection of the proximal humerus often includes the greater tuberosity and adjacent diaphysis, which may result in poor function secondary to loss of the rotator cuff and/or deltoid function.

Unplanned surgical excision of extremity soft tissue sarcomas: patient profile and referral patterns.

Unplanned surgical excision of sarcomas remains a major treatment dilemma in the control of local disease. The purpose of this study is to develop a patient profile to identify patients at high risk for an unplanned excision. The study group consisted of 54 patients following an unplanned excision of a soft tissue sarcoma.

A preliminary report on intra-sheath peroneal tendon subluxation: a prospective review of 7 patients with ultrasound verification.

Unlabelled: Peroneal tendon dislocation with recurrent subluxation over the lateral malleolus, both acute and chronic, is well documented in the literature. However, there remains a subset of patients who report symptoms similar to peroneal subluxation that do not actually display active or passive displacement of the tendon over the lateral malleolus. In this article, we describe 7 patients who were followed prospectively for the treatment of ultrasound-confirmed, retrofibular, intrasheath subluxation without the typical lateral subluxation or dislocation of the tendon over the malleolus.

The outcome of composite bone graft substitute used to treat cavitary bone defects.

Although autogenous bone graft remains the gold standard graft material, it is associated with an unacceptably high incidence of morbidity. Furthermore, operative time, blood loss, and length of hospitalization are often increased. In order for a graft substitute to replicate the optimal bone healing properties of autogenous graft, 3 essential elements must be present: scaffolding for osteoconduction, growth factors for osteoinduction, and progenitor cells for osteogenesis.

Intracranial metastasis from synovial sarcoma.

Synovial sarcomas comprise between 5% to 10% of all soft tissue sarcomas in adults. It has a predilection for young adults and is one of the more frequently misdiagnosed soft tissue sarcomas. It is not unusual for synovial sarcoma to present initially after a traumatic event.

Ultrasound of target joints for the evaluation of possible inflammatory arthropathy: associated clinical factors and diagnostic accuracy.

Objective: To examine the clinical features associated with an ultrasound (US) diagnosis of synovitis and/or erosions in patients suspected of inflammatory arthritis, and the factors associated with this evolution in patients with a normal initial US.

Patients And Methods: Cross-sectional: the records of 144 patients who underwent US for suspected inflammatory arthropathy were categorized into synovitis and/or erosions present or not. Longitudinal: of 58 patients without synovitis and/or erosions, 30 could be located and 19 agreed to be studied (two were asymptomatic and refused, nine could not be reached).