Extremes of Emergency Department Boarding are Associated With Poorer Financial Performance Among Hospitals.

Goal: Boarding emergency department (ED) patients is associated with reductions in quality of care, patient safety and experience, and ED operational efficiency. However, ED boarding is ultimately reflective of inefficiencies in hospital capacity management. The ability of a hospital to accommodate variability in patient flow presumably affects its financial performance, but this relationship is not well studied.

Applying Dynamic Systems to Social Media by Using Controlling Stability.

This study focuses on hybrid synchronization, a new synchronization phenomenon in which one element of the system is synced with another part of the system that is not allowing full synchronization and nonsynchronization to coexist in the system. When , where and are the state vectors of the drive and response systems, respectively, and Wan ( = ∓1)), the two systems' hybrid synchronization phenomena are realized mathematically. Nonlinear control is used to create four alternative error stabilization controllers that are based on two basic tools: Lyapunov stability theory and the linearization approach.

Boarding is Associated with Reduced Emergency Department Efficiency that is not Mitigated by a Provider in Triage.

Introduction: Boarding of patients in the emergency department (ED) is associated with decreased ED efficiency. The provider-in-triage (PIT) model has been shown to improve ED throughput, but it is unclear how these improvements are affected by boarding. We sought to assess the effects of boarding on ED throughput and whether implementation of a PIT model mitigated those effects.

Acute Respiratory Failure from Cement Exposure: A Case Report and Review of the Literature.

Cement is widely used in construction. Acute exposures with immediate sequelae have been infrequently described. This case report describes a man who developed multifocal pneumonitis with acute respiratory distress syndrome (ARDs) and respiratory failure one day after cement dust exposure.

Financial Implications of Physician Specialty Choice.

Purpose: To examine the approximated financial outcomes of physicians by specialty and to determine whether these correlate with mean USMLE Step 1 scores.

Methods: Specialty-specific data from the Association of American Medical Colleges Careers in Medicine website were analyzed for total length of training, mean USMLE Step 1 scores, average hours worked per week, and median clinical practice salary for physicians. Hourly wage and estimated net worth at retirement were calculated.

Transient Orbital Compartment Syndrome Caused by Spontaneous Lamina Papyracea Dehiscence.

Orbital compartment syndrome typically occurs due to trauma or burns. Here we discuss a case of spontaneous lamina papyracea dehiscence associated with transient orbital compartment syndrome. A previously healthy woman presented to the Emergency Department complaining of unilateral eye pain after nose blowing.

Disparate survival trends in histologic subtypes of metastatic non-small cell lung cancer: a population-based analysis.

Erlotinib, bevacizumab, and pemetrexed improved survival of metastatic non-small cell lung cancer (mNSCLC) in clinical trials, but their benefits are restricted to non-squamous histology. We studied recent survival trends in mNSCLC subpopulations defined by histology and associated clinical factors correlating with adenocarcinoma or endothelial growth factor receptor mutations. Using the Surveillance, Epidemiology and End Results database, we calculated relative survival at 1 year from diagnosis for mNSCLC cases diagnosed in 2000-2011.

Survival of patients with neuroendocrine carcinoma of the colon and rectum: a population-based analysis.

Background: High-grade neuroendocrine carcinoma is a rare colorectal pathology described in a case series. The role of surgery in this disease has been questioned.

Objective: The purpose of this work was to describe the incidence, management, and outcomes of neuroendocrine carcinoma in comparison with high-grade adenocarcinoma.

Disparate survival outcomes after front-line chemoimmunotherapy in older patients with follicular, nodal marginal zone and small lymphocytic lymphoma.

Using Surveillance, Epidemiology and End Results (SEER)-Medicare data (1996-2010), we compared survival and toxicity outcomes in 6993 patients older than 65 years with follicular (FL), nodal marginal zone (NMZL) and small lymphocytic lymphoma (SLL) receiving front-line therapy with rituximab (R), RCHOP (R, cyclophosphamide, doxorubicin, vincristine, prednisone), RCVP (R, cyclophosphamide, vincristine, prednisone) or R-fludarabine-containing regimens within 3 years from diagnosis. We demonstrated significant heterogeneity by histology after various regimens in multivariable survival models. Compared with RCHOP, overall survival was inferior with fludarabine-based regimens in FL (hazard ratio [HR] 1.

Observations in lung cancer over multiple decades: an analysis of outcomes and cost at a single high-volume institution.

Objectives: This study reviews survival outcomes and cost of lung cancer care over multiple decades at a single high-volume institution.

Methods: All patients with a diagnosis of lung cancer were analysed at a single institution from 1959 to 2010. Data were extracted from a tumour registry, which was linked to a longitudinal medical record, clinical data repository and social security master death index.

Disparate survival and risk of secondary non-Hodgkin lymphoma in histologic subtypes of Hodgkin lymphoma: a population-based study.

We compared survival outcomes and rates of secondary non-Hodgkin lymphoma (NHL) in 28 323 patients with nodular lymphocyte predominant (NLPHL) and classical Hodgkin lymphoma (HL) from the Surveillance, Epidemiology and End Results database, diagnosed between 1995 and 2010. In a multivariate analysis NLPHL demonstrated a significantly better relative survival (5-year risk of lymphoma-related death 5.7%, hazard ratio [HR] 0.

Comparative outcomes of rituximab-based systemic therapy and splenectomy in splenic marginal zone lymphoma.

Despite diagnostic and therapeutic advances, the majority of patients with splenic marginal zone lymphoma (SMZL) are still treated with splenectomy. We analyzed survival outcomes after surgery or rituximab-based systemic therapy in the Surveillance Epidemiology and End Results-Medicare database, using inverse probability of treatment weighting to minimize treatment selection bias. From the 657 recorded cases diagnosed between 2000 and 2007, with a median age of 77 years, we selected 227 eligible patients treated with splenectomy (68 %), rituximab alone (23 %), or in combination with chemotherapy (9 %) within 2 years from diagnosis.