Increasing the Connectivity and Autonomy of RNs with Low-Risk Obstetric Patients.

Unlabelled: : Objective: RNs are adopting an ever-larger role in health care models designed to reduce costs, increase patient satisfaction, and improve patient outcomes. Most research exploring such models has focused on those involving physicians or advanced practice nurses rather than RNs. This study explored the perspectives of patients, RNs, and other providers regarding a new prenatal connected care model for low-risk patients aimed at reducing in-office visits and creating virtual patient-RN connections.

Propofol Disposal in the Anesthesia Setting: Overcoming Barriers.

Propofol accounts for 41% of reported substance abuse cases among anesthesia providers. No guidelines outline appropriate propofol disposal in the healthcare setting. The lack of controlled disposal presents concerns for environmental harm, economic waste, and diversion.

Improving Quality of Chest Radiographs After Placement of Peripherally Inserted Central Catheters.

The goal of this study was to determine the best method for localizing peripherally inserted central catheters (PICCs) in postplacement portable chest radiographs. A retrospective analysis showed no significant difference in visualization of the PICC tip between different chest radiograph projections. Modifications were made to an institutional PICC protocol to obtain anteroposterior chest views with the guidewire present only.

An acute care approach to functional abdominal pain.

Functional abdominal pain disorders are commonly seen in the acute care setting and can be a source of frustration for patients and providers given their inherent chronic nature. However, an understanding of both the general approach to these disorders and the approach to specific common subtypes can help alleviate this frustration and lead to both short-term and long-term therapeutic success. This article describes the pathophysiology of these disorders and outlines a diagnostic and therapeutic approach to commonly seen functional abdominal pain disorders in adults.

Novel Assessment of Interstitial Lung Disease Using the "Computer-Aided Lung Informatics for Pathology Evaluation and Rating" (CALIPER) Software System in Idiopathic Inflammatory Myopathies.

Purpose: To evaluate the correlation between measurements from quantitative thoracic high-resolution CT (HRCT) analysis with "Computer-Aided Lung Informatics for Pathology Evaluation and Rating" (CALIPER) software and measurements from pulmonary function tests (PFTs) in patients with idiopathic inflammatory myopathies (IIM)-associated interstitial lung disease (ILD).

Methods: A cohort of patients with IIM-associated ILD seen at Mayo Clinic was identified from medical record review. Retrospective analysis of HRCT data and PFTs at baseline and 1 year was performed.

Informed Consent in Dentistry.

A review of literature regarding informed consent in dentistry reveals a paucity of information and minimal scholarship devoted to this subject. But this begs the question about informed consent somehow being different for dentistry than for medicine or other healthcare delivery. My account draws distinctions where appropriate but is rooted in the premise that informed consent is an ethical construct applicable to vulnerable people as patients independent of what type of treatment or body part being considered.

Influence of Psychiatric Symptoms on Decisional Capacity in Treatment Refusal.

How psychiatric symptoms affect patients' decision making in practice can inform how we think-theoretically and conceptually-about what it means for those patients to have decision-making capacity. Assessment of a patient's decisional capacity allows those with adequate capacity to make choices regarding treatment and protects those who lack capacity from potential harm caused by impaired decision making. In analyzing a case in which a patient with stage II breast cancer refuses further treatment, we review the conceptual model of informed consent and approaches to assessing decision-making capacity that are in accordance with the American Medical Association Code of Medical Ethics as well as tools to assess decisional capacity.

Unsupervised network mapping of commercially available immunoassay yields three distinct chronic rhinosinusitis endotypes.

Background: Endotyping chronic rhinosinusitis (CRS) through simplified cytokine assays may help direct individualized therapy such as corticosteroids, antibiotics, or biologics. We performed an unsupervised network analysis to endotype CRS and control subjects using a commercially available cytokine-chemokine immunoassay.

Methods: A 41-plex cytokine-chemokine array along with major basic protein (MBP) assay was performed on sinonasal surgical tissue of 32 adults.

Acute kidney injury in a patient with hemolytic anemia and thrombocytopenia.

Atypical hemolytic uremic syndrome (HUS) is clinically difficult to distinguish from HUS and thrombotic thrombocytopenic purpura. Atypical HUS results from dysregulation of complement activation causing thrombotic microangiopathy affecting multiple organ systems. Atypical HUS is associated with high morbidity and mortality, making early recognition and appropriate therapy necessary to improve patient outcomes.

Primary care providers' experiences with and perceptions of personalized genomic medicine.

Objective: To assess primary care providers' (PCPs') experiences with, perceptions of, and desired role in personalized medicine, with a focus on cancer.

Design: Qualitative study involving focus groups.

Setting: Urban and rural interprofessional primary care team practices in Alberta and Ontario.

Impact of Pharmacist-Provided Medication Therapy Management on Healthcare Quality and Utilization in Recently Discharged Elderly Patients.

Background: The optimization of medication use during care transitions represents an opportunity to improve overall health-related outcomes. The utilization of clinical pharmacists during care transitions has demonstrated benefit, although the optimal method of integration during the care transition process remains unclear.

Objective: To evaluate the impact of pharmacist-provided telephonic medication therapy management (MTM) on care quality in a care transitions program (CTP) for high-risk older adults.

The Incremental Role of Magnetic Resonance Imaging for Prostate Cancer Staging before Radical Prostatectomy.

Unlabelled: In the present report we aimed to analyze the incremental value of preoperative magnetic resonance imaging (MRI), in addition to clinical variables and clinically-derived nomograms, in predicting outcomes radical prostatectomy (RP). All Mayo Clinic RP patients who underwent preoperative 1.5-Tesla MRI with endo-rectal coil from 2003 to 2013 were identified.

An incorrect diagnosis and an unexpected cause of respiratory failure.

Thoracic aortic aneurysms often are asymptomatic or cause nonspecific symptoms such as cough, dyspnea, wheezing, or dysphagia. Acute onset of severe chest, neck, back, or abdominal pain may indicate an aortic rupture or dissection. Early identification and treatment, including optimized medical management and evaluation for surgical intervention, are necessary to improve patient outcomes.

Gender-specific analysis of outcomes from endoscopic sinus surgery for chronic rhinosinusitis.

Background: Women electing endoscopic sinus surgery (ESS) for chronic rhinosinusitis (CRS) report higher symptom burden but have lower computed tomography (CT) scores. Gender-specific analysis of outcomes from ESS therefore merits further study. The objective of this work was to study gender-specific differences in outcomes from ESS for CRS by analyzing preoperative and postoperative 22-item Sino-Nasal Outcome Test (SNOT-22) scores.

Gender-specific differences in chronic rhinosinusitis patients electing endoscopic sinus surgery.

Background: The objective of this study was to investigate gender-specific differences in chronic rhinosinusitis (CRS) patients electing endoscopic sinus surgery (ESS).

Methods: This study was a retrospective review of CRS patients electing ESS (2011-2013) at a tertiary-care center.

Results: ESS was elected by 272 patients (mean age 54.

Preferences Regarding Return of Genomic Results to Relatives of Research Participants, Including after Participant Death: Empirical Results from a Cancer Biobank.

Data are lacking with regard to participants' perspectives on return of genetic research results to relatives, including after the participant's death. This paper reports descriptive results from 3,630 survey respondents: 464 participants in a pancreatic cancer biobank, 1,439 family registry participants, and 1,727 healthy individuals. Our findings indicate that most participants would feel obligated to share their results with blood relatives while alive and would want results to be shared with relatives after their death.

Returning a Research Participant's Genomic Results to Relatives: Analysis and Recommendations.

Genomic research results and incidental findings with health implications for a research participant are of potential interest not only to the participant, but also to the participant's family. Yet investigators lack guidance on return of results to relatives, including after the participant's death. In this paper, a national working group offers consensus analysis and recommendations, including an ethical framework to guide investigators in managing this challenging issue, before and after the participant's death.

Diagnosis and medical and surgical management of cervical spondylotic myelopathy.

Cervical spondylotic myelopathy is a complex condition with subtle history and examination findings that mimic other conditions. Primary care physician assistants often are the first providers to evaluate these patients. This article describes cervical spondylotic myelopathy, its diagnosis and management, and recent data that offer strong evidence that patients who undergo surgical decompression show significant improvement over patients who are treated conservatively.