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Medicine Department (medicine + department)

Distribution by Scientific Domains
Medical Sciences100%

Kinds of Medicine Department

  • internal medicine department
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    Selected Abstracts

    Improved aetiological diagnosis of ischaemic stroke in a Vascular Medicine Unit , the significance of transesophageal echocardiogram

    INTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 3 2008
    A. Martignoni
    Summary Background:, The TOAST study estimates that 34% of ischaemic strokes are of undetermined aetiology. Improvements in the diagnosis of the pathogenetic mechanism of ischaemic stroke would translate into a better care, in analogy to other fields of vascular and internal medicine. Objective:, To measure the reduction of undetermined aetiology strokes performing a set of additional diagnostic tests. Design:, Consecutive case series with historical controls. Setting:, Internal Medicine Ward with a stroke area (SA) admitting most stroke patients of a large hospital in Italy. Subjects:, A total of 179 ischaemic stroke patients admitted to SA in 2004,2005 compared with 105 ischaemic stroke patients admitted to the whole department in 2001. Intervention:, To perform more diagnostic tests, including transesophageal echocardiography (TEE), in the greatest possible number of ischaemic stroke inpatients admitted in SA of the Internal Medicine Department, in the years 2004,2005. Results:, More diagnostic tests were performed during the study period than in 2001, especially TEE (56% of patients in 2004,2005 vs. 3% of patients in 2001). We observed a significant reduction of undetermined aetiology from 38% in 2001 to 16% in 2004,2005 (p < 0.0001), largely for an increased identification of cases of cardio-embolic mechanism (from 18% to 40%, p = 0.0002). In the years 2004,2005 the fraction of patients on anticoagulant treatment at discharge was 21% vs. 12% in 2001 (p = 0.041). Conclusion:, Performing more tests, particularly TEE, brought improvements in the aetiological diagnosis of stroke, increasing cardio-embolism diagnosis and anticoagulant treatment. [source]

    Liver Disease in Heavy Drinkers With and Without Alcohol Withdrawal Syndrome

    ALCOHOLISM, Issue 1 2004
    E. Barrio
    Abstract: Background: Withdrawal syndrome is a hallmark of alcohol dependence. The characteristics of alcohol consumption, closely related to dependence, could influence the development of alcoholic liver disease. The study aimed to investigate if patients with severe alcohol withdrawal syndrome have a peculiar profile of liver disease. Methods: The study included 256 heavy drinkers (aged 19,75 years, 70.3% males) admitted to an Internal Medicine Department. Patients admitted for complications of liver disease were not included. Severe alcohol withdrawal syndrome (seizures, disordered perceptions, or delirium) developed in 150 patients (58.6%). Alcohol consumption (daily quantity, duration, and pattern [regular or irregular]) was assessed by questionnaire. Liver biopsy was performed in all cases. Results: Patients with alcohol withdrawal syndrome showed a lower prevalence of liver cirrhosis and a higher prevalence of alcoholic hepatitis than patients without it. The negative association of alcohol withdrawal syndrome with liver cirrhosis persisted after we adjusted for sex, daily intake, duration, and pattern of alcohol consumption. Alcoholic hepatitis was independently associated with the irregular pattern of alcohol consumption, which was closely associated with severe alcohol withdrawal syndrome. Conclusions: The profile of liver injury is different in heavy drinkers who develop and who do not develop a severe alcohol withdrawal syndrome when admitted to the hospital. [source]

    Chairperson and Faculty Gender in Academic Emergency Medicine Departments

    ACADEMIC EMERGENCY MEDICINE, Issue 8 2006
    David Cheng MD
    Objectives: Despite the influx of female physicians in academic medicine departments, there are a small number of women in faculty and departmental leadership positions in emergency medicine (EM). The objective of this study was to determine if the gender of the chairperson of an academic EM department is associated with the gender of the residency program director (RPD) and gender proportion of its faculty. Methods: This was a retrospective analysis of 133 academic EM departments using the Society for Academic Emergency Medicine online residency catalog, program Web site, or e-mail. Main outcome measures were proportion of female EM faculty and gender of the RPD. Results: Data were available for 133 academic departments. Women chaired 7.5% (n= 10) of departments and comprised 22.3% of all faculty and 15.0% (n= 20) of RPD positions. EM departments that were chaired by women had a significantly higher percentage of female faculty compared with those led by men (31% vs. 22%; p = 0.01). Similarly, departments that were chaired by women had a significantly higher proportion of female RPDs compared with those chaired by men (50% vs. 12%; p < 0.01). Compared with departments chaired by men, the RPD was 5.0 times (95% confidence interval = 1.9 to 27.8; p < 0.01) more likely to be a woman if the chairperson was also a woman. Conclusions: An academic EM department was more likely to have a higher proportion of female faculty and a female RPD when the department chairperson was female. [source]

    Appropriate utilization of hospital beds in internal medicine: evaluation in a tertiary care hospital

    JOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 3 2007
    Ömer Dizdar MD
    Abstract Aim, To assess the appropriateness of utilization of beds in the internal medicine department of a university hospital. Methods, The appropriateness of hospital stay was evaluated using the Appropriateness Evaluation Protocol. A random sample of 402 days of stay was assessed. Results, One hundred and thirty-nine days of stay (34.6%) were classified as inappropriate. The inappropriate stays were mostly secondary to hospital-related factors. The two major factors for inappropriate stays were ,inappropriate timing/delay in diagnostic procedures/consultations' (27%) and ,delay in obtaining test results' (27%). None of the factors including age, gender, residence and inpatient period was significantly related to inappropriate stay in univariate analysis. Conclusion, This study indicated that a significant portion of stays were inappropriate. Efforts to decrease particularly hospital-related factors associated with inappropriate stay are needed. [source]

    Chairperson and Faculty Gender in Academic Emergency Medicine Departments

    ACADEMIC EMERGENCY MEDICINE, Issue 8 2006
    David Cheng MD
    Objectives: Despite the influx of female physicians in academic medicine departments, there are a small number of women in faculty and departmental leadership positions in emergency medicine (EM). The objective of this study was to determine if the gender of the chairperson of an academic EM department is associated with the gender of the residency program director (RPD) and gender proportion of its faculty. Methods: This was a retrospective analysis of 133 academic EM departments using the Society for Academic Emergency Medicine online residency catalog, program Web site, or e-mail. Main outcome measures were proportion of female EM faculty and gender of the RPD. Results: Data were available for 133 academic departments. Women chaired 7.5% (n= 10) of departments and comprised 22.3% of all faculty and 15.0% (n= 20) of RPD positions. EM departments that were chaired by women had a significantly higher percentage of female faculty compared with those led by men (31% vs. 22%; p = 0.01). Similarly, departments that were chaired by women had a significantly higher proportion of female RPDs compared with those chaired by men (50% vs. 12%; p < 0.01). Compared with departments chaired by men, the RPD was 5.0 times (95% confidence interval = 1.9 to 27.8; p < 0.01) more likely to be a woman if the chairperson was also a woman. Conclusions: An academic EM department was more likely to have a higher proportion of female faculty and a female RPD when the department chairperson was female. [source]

    Risk of drug-related problems for various antibiotics in hospital: assessment by use of a novel method,

    PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 8 2008
    Hege Salvesen Blix MSc
    Abstract Purpose To investigate the use of antibiotics in hospitals, to explore drug-related problems (DRPs) linked to antibiotics and to introduce a novel way of expressing the risks accompanying use of various antibiotics. Methods Patients from internal medicine departments in four Norwegian hospitals were prospectively included in 2002. Demographics, drugs used, medical history, laboratory data and clinical/pharmacological risk factors were recorded. DRPs were identified by clinical pharmacists and assessed in multidisciplinary hospital teams. A new term, the drug risk ratio, was established and defined as the number of times the antibiotic was associated with DRPs in relation to the number of times it was used. Results Out of the 668 patients included, 283 patients (42%) used antibiotics (AB users). AB users were older (76.2 vs. 73.9), used more drugs on admission (5.1 vs. 4.4) and had more DRPs (3.0 vs. 2.2) than non-users. The DRP categories no further need for drug, non-optimal drug and non-optimal dose were most frequently observed. The drug risk ratio, calculated for 12 antibiotic groups, was highest for aminoglycosides (0.77), , -lactamase-resistant penicillins (0.56), macrolides (0.54) and quinolones (0.48) and lowest for first- and third-generation cephalosporins, 0.17 and 0.13, respectively. Conclusions Nearly half of the hospitalised patients were prescribed antibiotics and antibiotic associated DRPs occurred frequently. The drug risk ratio for the different antibiotic groups varied with a factor of six from the lowest to the highest. A high drug risk ratio would alert of antibiotics which require heightened awareness when going to be used in clinical practice. Copyright © 2008 John Wiley & Sons, Ltd. [source]