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Delawareans with current asthma who smoke--a snapshot. 特拉华州目前患有哮喘的吸烟者——一个快照。
Delaware medical journal Pub Date : 2015-05-01
Sangeeta Gupta
{"title":"Delawareans with current asthma who smoke--a snapshot.","authors":"Sangeeta Gupta","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>Because they experience respiratory symptoms, adults with asthma might be expected to avoid cigarette smoking. This study sought to determine whether Delawareans with asthma are less likely to smoke cigarettes than members of the general population.</p><p><strong>Methods: </strong>The authors used data from a combined sample of 8,560 Delaware adults (ages 18 years or older) who participated in the Behavior Risk Factor Surveillance System (2011 and 2012). Sampling weights were used in all analyses. In this cross-sectional study, 827 participants reported a physician diagnosis of asthma.</p><p><strong>Results: </strong>The prevalence of cigarette smoking is similar in Delawareans with and without asthma (20.91 percent and 20.30 percent respectively). After controlling for gender, race, and education, younger age groups had significantly higher odds of being current smokers. There was evidence that young adults (18-44 years) were six times more likely to be current smokers as compared to the 65 or older reference group.</p><p><strong>Conclusions: </strong>Delawareans with asthma do not appear to selectively avoid cigarette smoking. Specific smoking prevention and cessation efforts should be targeted to adults with asthma.</p>","PeriodicalId":75779,"journal":{"name":"Delaware medical journal","volume":"87 5","pages":"141-6"},"PeriodicalIF":0.0,"publicationDate":"2015-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33253806","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
Accidental methadone intoxication masquerading as asthma exacerbation with respiratory arrest in a six-year-old boy. 意外美沙酮中毒伪装成哮喘加重呼吸停止的六岁男孩。
Delaware medical journal Pub Date : 2015-05-01
Orel Swenson
{"title":"Accidental methadone intoxication masquerading as asthma exacerbation with respiratory arrest in a six-year-old boy.","authors":"Orel Swenson","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A 6-year-old boy is brought to the emergency department of a level 1 trauma center by emergency medical services (EMS) for presumed asthma exacerbation with subsequent unresponsiveness and transient bradycardia. The initial physician exam was remarkable for an unresponsive child, with diffusely diminished breath sounds bilaterally, accompanied by diffuse wheezing, as well as pinpoint pupils. This last observation led to the recommendation to attempt a dose of naloxone for a possible overdose prior to proceeding with intubation for the altered mental status. The child had a brisk response to the naloxone, was subsequently placed on a naloxone drip, and admitted to the hospital. Initial provider thoughts were that the naloxone had worked on an accidental overdose of over-the-counter dextromethorphan containing medication. These suspicions were later proven incorrect after mass spectrometry yielded a positive methadone presence in the urine. The child was ultimately discharged home with ongoing input from child protective services, without further medical complications. The increased utilization of methadone for the treatment of both opioid withdrawal, as well as for chronic pain management demands, heightened awareness of the clinicians, as cases such as this will continue to appear.</p>","PeriodicalId":75779,"journal":{"name":"Delaware medical journal","volume":"87 5","pages":"147-9"},"PeriodicalIF":0.0,"publicationDate":"2015-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33253807","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
The future of the maintenance of certification. 未来的维护认证。
Delaware medical journal Pub Date : 2015-05-01
Nancy Fan
{"title":"The future of the maintenance of certification.","authors":"Nancy Fan","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":75779,"journal":{"name":"Delaware medical journal","volume":"87 5","pages":"137-8"},"PeriodicalIF":0.0,"publicationDate":"2015-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33253805","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
Autopsies at the Christiana Care Health System: a short review of the last 28 years. 克里斯蒂安娜医疗保健系统的尸体解剖:对过去28年的简短回顾。
Delaware medical journal Pub Date : 2015-05-01
Mark L Mitchell
{"title":"Autopsies at the Christiana Care Health System: a short review of the last 28 years.","authors":"Mark L Mitchell","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":75779,"journal":{"name":"Delaware medical journal","volume":"87 5","pages":"151-4"},"PeriodicalIF":0.0,"publicationDate":"2015-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33253808","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
Utilizing digital breast tomosynthesis to improve accuracy of preoperative needle localization for surgical excisional biopsy. 利用数字乳腺断层合成提高手术切除活检术前针头定位的准确性。
Delaware medical journal Pub Date : 2015-04-01
Rabia Hasan, Sara C Gavenonis, Min-Chul F Shin
{"title":"Utilizing digital breast tomosynthesis to improve accuracy of preoperative needle localization for surgical excisional biopsy.","authors":"Rabia Hasan,&nbsp;Sara C Gavenonis,&nbsp;Min-Chul F Shin","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>We describe a case of an 88-year-old female who presented for needle localization to undergo excisional biopsy of a subtle asymmetry in the left breast, with successful localization achieved using digital breast tomosynthesis. Initial attempts at localization under 2D mammography were inaccurate. Subsequent digital breast tomosynthesis application for triangulation resulted in better visualization of the target, and successful localization. Specimen radiography confirmed the lesion was accurately targeted and pathology revealed ductal carcinoma in situ. Needle localization guided by mammography and inherent limitations of 2D mammography are discussed, along with a literature review of tomosynthesis guided needle localization.</p>","PeriodicalId":75779,"journal":{"name":"Delaware medical journal","volume":"87 4","pages":"117-20"},"PeriodicalIF":0.0,"publicationDate":"2015-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33348099","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
America's bitter pill. 美国的苦果。
Delaware medical journal Pub Date : 2015-04-01
Nancy Fan
{"title":"America's bitter pill.","authors":"Nancy Fan","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":75779,"journal":{"name":"Delaware medical journal","volume":"87 4","pages":"105-6"},"PeriodicalIF":0.0,"publicationDate":"2015-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33347680","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 emergency medicine residents and faculty have similar learning styles when assessed with the Kolb learning style assessment tool? 当使用Kolb学习风格评估工具进行评估时，急诊医学住院医师和教师是否有相似的学习风格?
Delaware medical journal Pub Date : 2015-04-01
Jenna Fredette, Corinne O'Brien, Christy Poole, Jason Nomura
{"title":"Do emergency medicine residents and faculty have similar learning styles when assessed with the Kolb learning style assessment tool?","authors":"Jenna Fredette,&nbsp;Corinne O'Brien,&nbsp;Christy Poole,&nbsp;Jason Nomura","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Experiential learning theory and the Kolb Learning Style Inventory (Kolb LSI) have influenced educators worldwide for decades. Knowledge of learning styles can create efficient learning environments, increase information retention, and improve learner satisfaction. Learning styles have been examined in medicine previously, but not specifically with Emergency Medicine (EM) residents and attendings. Using the Kolb LSI, the learning styles of Emergency Medicine residents and attendings were assessed. The findings showed that the majority of EM residents and attendings shared the accommodating learning style. This result was different than prior studies that found the majority of medical professionals had a converging learning style and other studies that found attendings often have different learning styles than residents. The issue of learning styles among emergency medical residents and attendings is important because learning style knowledge may have an impact on how a residency program structures curriculum and how EM residents are successfully, efficiently, and creatively educated.</p>","PeriodicalId":75779,"journal":{"name":"Delaware medical journal","volume":"87 4","pages":"109-12"},"PeriodicalIF":0.0,"publicationDate":"2015-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33347683","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
Imaging of a gastrobronchial fistula after gastric bypass surgery and the contrast dilemma. 胃分流术后胃支气管瘘的影像学及对比困境。
Delaware medical journal Pub Date : 2015-04-01
Assaf Graif, Kris Conde, Christopher A DeMauro
{"title":"Imaging of a gastrobronchial fistula after gastric bypass surgery and the contrast dilemma.","authors":"Assaf Graif,&nbsp;Kris Conde,&nbsp;Christopher A DeMauro","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Obesity and bariatric procedures have become more common in the United States over the past 20 years. Therefore, the incidence of previously rare complications is also on the rise. One of the more ominous complications is a gastric leak with subsequent creation of a fistulous tract. A very rare subset of this complication is when the fistulous tract connects the gastric pouch to the bronchial tree. Several contrast agents can be utilized for imaging of the upper gastrointestinal tract, some of which may cause significant adverse effects if not properly tailored to the specific pathology in question. We present a case of a gastrobronchial fistula developing several years after a laparoscopic Roux-en-Y gastric bypass and discuss the ideal choice of contrast material when imaging this specific pathology.</p>","PeriodicalId":75779,"journal":{"name":"Delaware medical journal","volume":"87 4","pages":"113-6"},"PeriodicalIF":0.0,"publicationDate":"2015-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33348098","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
Inter-observer reliability of the ankle-brachial index in a pediatric setting. 小儿踝臂指数的观察者间信度。
Delaware medical journal Pub Date : 2015-03-01
Ellen M Dean, Kenneth Rogers, Mihir M Thacker, Richard W Kruse
{"title":"Inter-observer reliability of the ankle-brachial index in a pediatric setting.","authors":"Ellen M Dean,&nbsp;Kenneth Rogers,&nbsp;Mihir M Thacker,&nbsp;Richard W Kruse","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>The aim of our study was to determine the inter-observer reliability of the ankle-brachial index (ABI) in the pediatric population. This was done to determine if this simple diagnostic test could be utilized in lieu of CT angiograms to reduce radiation exposure to children sustaining trauma, particularly physeal fractures about the knee.</p><p><strong>Design: </strong>Diagnostic study of consecutive patients with no applied \"gold-standard\" test.</p><p><strong>Setting: </strong>Level I pediatric hospital.</p><p><strong>Patients/participants: </strong>Thirty consecutive patients from a busy fracture clinic were recruited. Patients ranged in age from 7-17 years.</p><p><strong>Intervention: </strong>Manual systolic blood pressure measurements from uninjured limbs were taken by two independent attending orthopaedic surgeons from the ipsilateral brachial, dorsalis pedis, and posterior tibial arteries of each patient.</p><p><strong>Main outcome measurements: </strong>The intraclass correlation coefficients from each anatomic area were calculated.</p><p><strong>Results: </strong>Intraclass correlation of measurements from all three anatomic locations showed good inter-observer reliability. The intraclass correlation coefficients from the brachial, dorsalis pedis, and posterior tibial arteries were 0.699, 0.815, and 0.740, respectively. Therefore, the calculation of the ABI was consistent between the two observers despite any variability in individual pressure measurements.</p><p><strong>Conclusions: </strong>The ABI is a fast, non-invasive test that can be applied to the pediatric population in the evaluation of lower extremity arterial injury associated with orthopaedic trauma. It can obviate the need for tests such as CT angiograms that have inherent risks, particularly those associated with radiation exposure that are of concern in a young child.</p>","PeriodicalId":75779,"journal":{"name":"Delaware medical journal","volume":"87 3","pages":"77-80"},"PeriodicalIF":0.0,"publicationDate":"2015-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33313310","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
What makes it work? 是什么让它起作用的?
Delaware medical journal Pub Date : 2015-03-01
Nancy Fan
{"title":"What makes it work?","authors":"Nancy Fan","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":75779,"journal":{"name":"Delaware medical journal","volume":"87 3","pages":"73-4"},"PeriodicalIF":0.0,"publicationDate":"2015-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33313309","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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