Are You Using the Right Electronic Health Record?

With the enactment of the Health Information Technology for Economic and Clinical Health (HITECH) Act in 2009, hospitals and physician practices across the country converted from a system of paper recordkeeping to fully integrated electronic health records (EHR)., With financial incentives in hand, there was a rush to market to acquire and implement these systems. Fast-forward 10 years, and it is apparent that the EHR space has significantly evolved in technology, processes, and policies.

Altered physical pain processing in different psychiatric conditions.

Several reports indicate either increased or decreased pain sensitivity associated with psychiatric disorders. Chronic pain is highly prevalent in many of these conditions. We reviewed the literature regarding experimental pain sensitivity in patients with major depression, bipolar disorder, posttraumatic stress disorder (PTSD), generalized anxiety disorder, panic disorder, obsessive-compulsive disorder and schizophrenia.

The impact of biological sex and sex hormones on cognition in a rat model of early, pre-motor Parkinson's disease.

Parkinson's disease (PD) is well known for motor deficits such as bradykinesia. However, patients often experience additional deficits in working memory, behavioral selection, decision-making and other executive functions. Like other features of PD, the incidence and severity of these cognitive symptoms differ in males and females.

Mechanisms of hearing loss after blast injury to the ear.

Given the frequent use of improvised explosive devices (IEDs) around the world, the study of traumatic blast injuries is of increasing interest. The ear is the most common organ affected by blast injury because it is the body's most sensitive pressure transducer. We fabricated a blast chamber to re-create blast profiles similar to that of IEDs and used it to develop a reproducible mouse model to study blast-induced hearing loss.

United States version of the Stroke Driver Screening Assessment: a pilot study.

Background: Most stroke survivors who resume driving in the United States do so within the first year. More than 87% of these individuals resume driving without a formal evaluation of their fitness to drive because of the absence of standard practices and generally accepted and valid screening tools. The Stroke Driver Screening Assessment (SDSA) is an established battery for predicting stroke survivors' driving performance but is not currently used in the United States.

Cue-induced conditioned activity does not incubate but is mediated by the basolateral amygdala.

Re-exposure to drug-associated cues causes significant drug craving in recovering addicts, which may precipitate relapse. In animal models of craving, drug-seeking responses for contingent delivery of drug-associated cues sensitizes or "incubates" across drug withdrawal. To date there is limited evidence supporting an incubation effect for behaviors mediated by non-contingent presentation of drug-associated cues.

Residents as teachers: residents' perceptions before and after receiving instruction in clinical teaching.

Context: Residents play an integral role in educating junior residents, medical students, and patients.

Objective: To determine how residents describe their training, proficiency, and comfort level in teaching before and after receiving instruction in clinical teaching.

Methods: Emergency medicine residents at a 980-bed suburban hospital system filled out a 12-question survey on their training as teachers and their self-perceptions of themselves as teachers.

Prediction of driving ability in people with relapsing-remitting multiple sclerosis using the stroke driver screening assessment.

The ability to drive is often affected in individuals with multiple sclerosis (MS) because of the motor, visual, or cognitive deficits commonly associated with the condition. In this study, we investigated the accuracy with which the Stroke Driver Screening Assessment (SDSA), an established battery for the prediction of driving performance of stroke survivors, would predict driving performance of individuals with MS. Driving performance of 44 individuals with relapsing-remitting MS (mean ± SD age, 46 ± 11 years; 37 females and 7 males) who were currently driving at least once a month was predicted using their performance on the SDSA.

Using magnetic resonance imaging for early assessment of submucous cleft palate: a case report.

Surgical correction for submucous cleft palate is generally indicated in the presence of velopharyngeal inadequacy. Clinical assessment of velopharyngeal inadequacy requires that the child is able to produce a connected speech sample, which can yield a delay in treatment decisions that extends through a critical period of speech and language development. A perceptual speech assessment and intraoral examination are traditionally the most important methods of establishing a diagnosis of submucous cleft palate.

Driving simulation for evaluation and rehabilitation of driving after stroke.

Driving is an important activity of daily living. Loss of driving privileges can lead to depression, decreased access to medical care, and increased healthcare costs. The ability to drive is often affected after stroke.

Efficacy of continuous positive airway pressure for treatment of hypernasality.

Objective: To determine whether speech hypernasality in subjects born with cleft palate can be reduced by graded velopharyngeal resistance training against continuous positive airway pressure (CPAP).

Design: Pretreatment versus immediate posttreatment comparison study.

Setting: Eight university and hospital speech clinics.

Magnetic resonance imaging in the evaluation of occult submucous cleft palate.

Objective: To explore the application of magnetic resonance imaging (MRI) in the evaluation of patients with occult submucous cleft palate and to use the MRI information obtained to aid in the treatment decision to perform surgery versus behavioral speech therapy.

Design: Prospective study with magnetic resonance (MR) images of subjects suspected of having occult submucous cleft palate.

Setting: Hospital and university-based.

Children awaiting invasive medical procedures: do children and their mothers agree on child's level of anxiety?

Examined correspondence between mother and child reports of child anxiety immediately preceding a scheduled invasive medical procedure. The State-Trait Anxiety Inventory for Children (STAIC) was administered to 101 children ages 10-18 years. Mothers completed the STAIC and the State-Trait Anxiety Inventory to assess their perceptions of the child's anxiety and their own level of anxiety, respectively.

Differences in microbicidal activities of human macrophages against Toxoplasma gondii and Trypanosoma cruzi.

The microbicidal activities of normal human pelvic macrophages against infection by the intracellular protozoa Toxoplasma gondii and Trypanosoma cruzi were examined. Macrophages allowed infection by T. gondii and yet possessed remarkable microbicidal activity against this organism.

Nonoxidative microbicidal activity in normal human alveolar and peritoneal macrophages.

Although Toxoplasma gondii multiplies within normal murine alveolar and peritoneal macrophages, it is killed by normal rat alveolar and peritoneal macrophages. The killing by rat macrophages is by a nonoxidative mechanism. Studies on normal human alveolar macrophages have reported disparate results in regard to their ability to inhibit or kill T.

[Significance of the time of administering substance P on learning and memory in rats].

We studied the influence of time and period of application of substance P (SP) on type and size of the effects on learning in Wistar rats. Treatment with SP before acquisition training had a fascillitating effect on learning. If SP was applied from the 1st or 3rd d of acquisition training there was no effect; if given from the 2nd d an inhibition was found; if given from the 4th d the consolidation of memory became finished.