Lung ultrasound more sensitive than X-ray for pediatric pneumonia | Ultrasound shows bowel wall thickening with ulcerative colitis flares | HIMSS: Use of disparate EMR vendors contributes to interoperability issues
May 17, 2018
Providing Ultrasound Information to Enhance Patient Care and Safety
Lung ultrasound for confirming pediatric community-acquired pneumonia had a 95.5% pooled sensitivity, 95.3% pooled specificity, 99% positive predictive value and 63.1% negative predictive value, according to an analysis of 12 studies involving 1,510 patients. Lung ultrasound is more sensitive than chest radiography for confirming suspected pCAP and has similar specificity, researchers reported in Pediatric Pulmonology.
Ultrasound images showed thickening of all three layers of the bowel as well as enlarged lymph nodes and mesenteric proliferation of fat around the bowel in patients with ulcerative colitis who experience clinical flares, researchers reported. Intestinal ultrasound can help clinicians see symptom improvement within six weeks of treatment, said gastroenterologist Christian Maaser, who is leading the study.
According to HIMSS Analytics data, interoperability problems arise from using disparate EMR vendors, with the average hospital having 16 distinct EHR platforms at their affiliated practices and most hospitals implementing at least 10 EHRs. The ONC and CMS must lead the effort to improve interoperability within the health care industry, an executive from HIMSS Analytics said.
Health care is a tactile profession, and in an age of hypersensitivity, providers who follow a few guidelines with patients and colleagues can avoid misunderstandings, writes Sue Jacques, a consultant who specializes in medical and corporate civility. Connect first with a handshake, ask before other kinds of touching, focus compliments on personal attributes or accomplishments instead of on appearance, and accept compliments and apologies gracefully, writes Jacques.
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Patients with nonalcoholic fatty liver disease have a higher likelihood of liver-related events if they have cirrhosis, while non-hepatic cancers and vascular events are more likely among those with bridging fibrosis, researchers wrote in Gastroenterology. Hepatic decompensation and hepatocellular carcinoma were more likely in patients with cirrhosis, and vascular events were more likely among patients with stage 3 fibrosis than those with stage 4 fibrosis.
A UK study in the European Heart Journal found lower diversity of healthy bacteria in the gut was associated with greater arterial stiffness among women. The findings, based on TwinsUK registry data for 617 adult women, also linked greater amounts of bacteria from the Ruminococcaceae family with lower arterial stiffness.
Stillbirths and neonatal deaths in the US decreased 11.5% from 2007 to 2015 based on data from the CDC's National Center for Health Statistics, according to a study in JAMA Pediatrics, and birth rates increased at the gestational age of 39 to 40 weeks while falling for other ranges. "A recent study presented at the Society for Maternal Fetal Medicine suggests that this is the optimal time for delivery ... so it's not surprising to see the number of deliveries during this time period increase," said maternal-fetal medicine specialist Haywood Brown, the president of the American College of Obstetricians and Gynecologists.
A study in the Clinical Journals of the American Society of Nephrology linked pediatric acute kidney injury to a nearly 40% and a 60% to 80% higher adjusted odds of hospitalizations one year and five years after discharge from a pediatric intensive care unit, respectively. The findings, based on data involving 2,041 youths, also associated AKI with increased frequency of five-year outpatient physician visits, but not with emergency department use.
The CMS is accepting proposed measures for inclusion in the Medicare Promoting Interoperability Program, formerly known as meaningful use. Stakeholders may submit ideas by June 29 that focus on the improvement of health data exchange and interoperability, advanced use of 2015 Edition certified EHR technology, patient safety, outcomes measurement, and streamlined program flexibility, effectiveness and efficiency.
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