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Academic Physician Perspectives on the Legalization and Practice of Physician-Assisted Suicide. 医师协助自杀合法化与实践的学术医师视角。
Connecticut Medicine Pub Date : 2016-10-01
Peter T Hetzler, Lydia S Dugdale
{"title":"Academic Physician Perspectives on the Legalization and Practice of Physician-Assisted Suicide.","authors":"Peter T Hetzler,&nbsp;Lydia S Dugdale","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In fewer than 20 years, five US states have legalized or decriminalized physician-assisted suicide (PAS), and in 2015, about half of all state legislatures considered legalizing it. Since it is medical doctors who typically perform PAS, it is important to understand physicians' views regarding legalization and willingness to perform it. The objective of this study was to determine what physicians believe about the legalization and practice of physician-assisted suicide. A 22 multiple-choice question survey was sent to 1251 current faculty physicians at the Yale School of Medicine. Four hundred and eighty-eight (39%) responded. The majority of physician respondents (73%) agreed that it is sometimes necessary to hasten death in order to relieve suffering. Of that 73%, only 29% indicated that they would actually perform physician-assisted suicide.</p>","PeriodicalId":35577,"journal":{"name":"Connecticut Medicine","volume":"80 9","pages":"559-561"},"PeriodicalIF":0.0,"publicationDate":"2016-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36108378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Trends in Fatal Pediatric Injury. 致命儿科伤害的趋势。
Connecticut Medicine Pub Date : 2016-10-01
Carrie Corrigan, Susan DiVietro, Brendan Campbell, Steven Rogers, Rebecca Beebe, Meghan Clough, Garry Lapidus
{"title":"Trends in Fatal Pediatric Injury.","authors":"Carrie Corrigan,&nbsp;Susan DiVietro,&nbsp;Brendan Campbell,&nbsp;Steven Rogers,&nbsp;Rebecca Beebe,&nbsp;Meghan Clough,&nbsp;Garry Lapidus","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>We studied youth injury fatality rates in America, the Northeast region of the US, andinthe state of Connecticut for the years 1990 and 2013 to evaluate the incidence of injury. All areas of injury showed a decrease in mortality rates with the exception of deaths by suffocation and poisoning. Ihe age group most affected by suffocation is infants younger than one year. Adolescents between the ages of 15 and 19 years appear to be at increased risk for poisoning deaths. Injury surveillance provides important guidance for the implementation of community based programs to prevent injury.</p>","PeriodicalId":35577,"journal":{"name":"Connecticut Medicine","volume":"80 9","pages":"517-524"},"PeriodicalIF":0.0,"publicationDate":"2016-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36107467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Health Literacy and Implications for Patient Care. 健康素养及其对病人护理的影响。
Connecticut Medicine Pub Date : 2016-09-01
Sundeep Bath, Fei Wang
{"title":"Health Literacy and Implications for Patient Care.","authors":"Sundeep Bath,&nbsp;Fei Wang","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":35577,"journal":{"name":"Connecticut Medicine","volume":"80 7","pages":"427-432"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40438453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Kikuchi-Fujimoto Disease in aYoung African American Male: Are we Seeing a Paradigm Shift in Disease Epidemiology? A Case Report. 年轻非裔美国男性的菊池-藤本病:我们是否看到了疾病流行病学的范式转变?一个病例报告。
Connecticut Medicine Pub Date : 2016-09-01
Vinay Rao, Frank Bauer, James J Vredenburgh
{"title":"Kikuchi-Fujimoto Disease in aYoung African American Male: Are we Seeing a Paradigm Shift in Disease Epidemiology? A Case Report.","authors":"Vinay Rao,&nbsp;Frank Bauer,&nbsp;James J Vredenburgh","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Kikuchi-Fujimoto disease (KFD), also known as histiocytic necrotizing lymphadenitis (HNL), is a rare, self-limiting disease most commonly reported in young Asian women worldwide. We present the case of a 27-year-old African American male who had three weeks of high-grade fevers, night sweats, a 10-pound weight loss, and tender unilateral posterior cervical lymphadenopathy. A complete workup of infectious, rheumatologic, and neoplastic diseases was pursued. Lymph node biopsies revealed histiocyte proliferation with areas of necrosis. These findings were diagnostic of KFD. While KFD has been reported most commonly in young Asian women, in the US, this disease must be considered in both males and females and in diverse ethnicities.</p>","PeriodicalId":35577,"journal":{"name":"Connecticut Medicine","volume":"80 7","pages":"409-412"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40438835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Posterior Reversible Encephalopathy Syndrome (PRES) Presenting as Status Epilepticus: A Case Report and Literature Review. 后可逆性脑病综合征(PRES)表现为癫痫持续状态:1例报告及文献复习。
Connecticut Medicine Pub Date : 2016-09-01
Prabin Sharma, Mohemmedd Khalid Abbas, Michael Huynh
{"title":"Posterior Reversible Encephalopathy Syndrome (PRES) Presenting as Status Epilepticus: A Case Report and Literature Review.","authors":"Prabin Sharma,&nbsp;Mohemmedd Khalid Abbas,&nbsp;Michael Huynh","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Posterior reversible encephalopathy syndrome (PRES) is one of many causes of status epilepticus (SE). Itis defined classically as a clinical radiographic entity, characterized by presentation of headache, altered mental status, visual disturbances, seizures, and typical neuroradiographic findings of symmetrical white-matter edema. Predisposing conditions include uncontrolled hypertension, eclampsia, and use of chemotherapeu- tic and immunosuppressant agents. Bevacizumab (Avastin), a monoclonal antibody against vascular endothelial growth factor (VEGF), is used in a combination with FOLFOX [FOL - Folinic acid; F - Fluorouracil (5-FU); OX - Oxaliplatin] as a first-line treatment for patients with metastatic colorectal cancer. We present a case of a 52-year-old male on systemic chemotherapy with FOLFOX and bevacizumab who presented with SE and was diagnosed with PRES. His symptoms resolved with intensive control of blood pressure and discontinuation of chemotherapy. Bevacizumab-induced vasospasm, endothelial and blood-brain-barrier dysfunction, in combination with elevated blood pressure, were likely the underlying mechanism of PRES in our patient.</p>","PeriodicalId":35577,"journal":{"name":"Connecticut Medicine","volume":"80 8","pages":"475-478"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36116026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Transition from Volume to Value: Medication Management after HosDital Discharge in the Elderly. 从量到值的转变:老年人出院后用药管理。
Connecticut Medicine Pub Date : 2016-09-01
Ann Tran, Sean M Jeffery, Michael D Nailor
{"title":"Transition from Volume to Value: Medication Management after HosDital Discharge in the Elderly.","authors":"Ann Tran,&nbsp;Sean M Jeffery,&nbsp;Michael D Nailor","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":35577,"journal":{"name":"Connecticut Medicine","volume":"80 8","pages":"495-501"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36116028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Do Patients Like Their Physicians? The Physicians Foundation 2016 Patient Survey. 病人喜欢他们的医生吗?医师基金会2016年患者调查。
Connecticut Medicine Pub Date : 2016-09-01
Michael D Deren
{"title":"Do Patients Like Their Physicians? The Physicians Foundation 2016 Patient Survey.","authors":"Michael D Deren","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":35577,"journal":{"name":"Connecticut Medicine","volume":"80 8","pages":"505-506"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36116029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Emergency Departments in Connecticut: A Report Utilizing the National Emergency Department Inventory Survey. 康涅狄格州的紧急部门:一份利用国家紧急部门库存调查的报告。
Connecticut Medicine Pub Date : 2016-09-01
Shih-Chuan Chou, Elizabeth Schiller, Mohammad K Faridi, Janice A Espinola, Ali S Raja, Carlos A Camargo, Arjun K Venkatesh
{"title":"Emergency Departments in Connecticut: A Report Utilizing the National Emergency Department Inventory Survey.","authors":"Shih-Chuan Chou,&nbsp;Elizabeth Schiller,&nbsp;Mohammad K Faridi,&nbsp;Janice A Espinola,&nbsp;Ali S Raja,&nbsp;Carlos A Camargo,&nbsp;Arjun K Venkatesh","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To describe the current state of emergency departments in Connecticut.</p><p><strong>Methods: </strong>We analyzed Connecticut data from the National Emergency Department Inventory - Nev England survey. We categorized emergency departments (EDs) into high-volume (> 50 000 annual vis its) vs low-volume (< 50000 visits).</p><p><strong>Results: </strong>31 (89%) Connecticut EDs responded. The median annual ED visit volume was 45,000 visits with 20 (65%) EDs reported being \"at or over capacity,\" including nearly all high-volume EDs. Only 1: (35%) EDs had pediatric emergency care coordinators, and access to specialties varied with notable shortages in neurology, neurosurgery, plastic sur- gery, and hand surgery. Electronic health records had near universal adoption but video consultation utilization was limited. Computer tomography and point-of-care ultrasound was widely available.</p><p><strong>Conclusion: </strong>While Connecticut EDs reported the ability to provide a broad array of emergency care services, policymakers seeking to improve acute care access should focus efforts on crowding and pediatric emergency care, as well as video consultation adoption.</p>","PeriodicalId":35577,"journal":{"name":"Connecticut Medicine","volume":"80 8","pages":"453-462"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36116133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cost Savings Associated with the Adoption of a Cloud Computing Data Transfer System for Trauma Patients. 创伤患者采用云计算数据传输系统可节省成本。
Connecticut Medicine Pub Date : 2016-09-01
James M Feeney, Stephanie C Montgomery, Laura Wolf, Vijay Jayaraman, Michael Twohig
{"title":"Cost Savings Associated with the Adoption of a Cloud Computing Data Transfer System for Trauma Patients.","authors":"James M Feeney,&nbsp;Stephanie C Montgomery,&nbsp;Laura Wolf,&nbsp;Vijay Jayaraman,&nbsp;Michael Twohig","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Among transferred trauma patients, challenges with the transfer of radiographic studies include problems loading or viewing the studies at the receiving hospitals, and problems manipulating, reconstructing, or evalu- ating the transferred images. Cloud-based image transfer systems may address some ofthese problems.</p><p><strong>Methods: </strong>We reviewed the charts of patients trans- ferred during one year surrounding the adoption of a cloud computing data transfer system. We compared the rates of repeat imaging before (precloud) and af- ter (postcloud) the adoption of the cloud-based data transfer system.</p><p><strong>Results: </strong>During the precloud period, 28 out of 100 patients required 90 repeat studies. With the cloud computing transfer system in place, three out of 134 patients required seven repeat films.</p><p><strong>Conclusion: </strong>There was a statistically significant decrease in the proportion of patients requiring repeat films (28% to 2.2%, P < .0001). Based on an annualized volume of 200 trauma patient transfers, the cost savings estimated using three methods of cost analysis, is between $30,272 and $192,453.</p>","PeriodicalId":35577,"journal":{"name":"Connecticut Medicine","volume":"80 7","pages":"389-392"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40438826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Case Report: What is Your Differential Diagnosis for Bilateral Cerebellar Infarct? 病例报告:双侧小脑梗死的鉴别诊断是什么?
Connecticut Medicine Pub Date : 2016-09-01
Aaron Snyder, Tina Chen, Kalilah Hunter-Anderson, Douglas Fellows
{"title":"Case Report: What is Your Differential Diagnosis for Bilateral Cerebellar Infarct?","authors":"Aaron Snyder,&nbsp;Tina Chen,&nbsp;Kalilah Hunter-Anderson,&nbsp;Douglas Fellows","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Neurovascular variants are not frequently described outside of specialty literature. Infarction involving these atypical neurovascular structures present with unusual clinical findings and radiologic imaging. A 63-year-old man with hypertension, diabetes, and former tobacco use presented from the Department of Corrections with global headache, nausea, vomiting, and double vision. He was found to be hypertensive to 240/120. CT imaging noted acute ischemic changes in the bilateral posterior inferior cerebellar artery distribution. Follow up 3-D time-of-flight (TOF) magnetic resonance angiography (MRA) of the cranial region demonstrated abrupt cut off of an azygous right posterior inferior cerebellar artery (PICA) and presumed absence of the left PICA. The patient underwent occipital craniotomy for evolving ischemic stroke and development of hydrocephalus, and ultimately recovered without neurologic deficits.</p>","PeriodicalId":35577,"journal":{"name":"Connecticut Medicine","volume":"80 7","pages":"419-421"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40438452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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