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Biomedical subjects

K Ratzan

Publications and source records attributed to K Ratzan.

5 recordsLinked to original sources
PubMed1994

Performance on the internal medicine second-year residency in-training examination predicts the outcome of the ABIM certifying examination.

For 223 residents from eight teaching hospitals, the results of the second-year in-training examination and the first-sitting certifying examination of the American Board of Internal Medicine were highly correlated. The results of the in-training examination can serve residents as an important measure of their preparedness for certification and can be useful in identifying the need for more intensive self-study strategies during the subsequent one and a half years.

Certification↗
PubMed1987

Changing prescribing patterns: a program of physician education.

A drug utilization review identified significant inappropriate use of second-generation cephalosporins at a 700-bed community teaching hospital. As a result, an educational program designed to modify physician prescribing patterns was developed as a cost-containment measure. Educational guidelines listing indications and contraindications for cefamandole and cefoxitin and comparing their costs with those of first-generation cephalosporins were placed in patient records, and physician use of these agents was reviewed before, during, and after the intervention. The rate of combined appropriate use of cefamandole and cefoxitin increased from 30 to 58% during the study. A change from the second-generation cephalosporins to therapeutically equivalent, less-expensive drugs was noted in 28% of patients' medical records within 48 hours after placement of the guidelines. This educational program proved to be a low-cost method of successfully altering the prescribing patterns of physicians.

Cephalosporins↗
PubMed1983

An investigation of enterococcal bacteremia.

Records of all 34 patients with positive blood cultures for enterococcus at Mount Sinai Medical Center of Greater Miami in 1981 were reviewed. Twenty-four true bacteremias were identified from sources including the pelvis/abdomen (9), urinary tract (6), wounds (2), IV catheter (2), contaminated needle (1), endocarditis (1), and primary bacteremia (3). Sixteen of the 24 true bacteremias were hospital acquired, and these infections accounted for 7 of 9 (78%) fatal outcomes. Fourteen of 16 patients with hospital-acquired infection received prior antibiotic therapy. Eight (24%) of the original 34 patients had positive blood cultures for enterococcus as a result of cross-contamination from an automated blood culture analyzer. The rate of cross-contamination per positive blood culture for enterococcus in 1981 was 22%. Two remaining patients in the original series could not be placed in a category of true infection or cross-contaminant. Although there was a real increase in the number of enterococcal bacteremias in 1981, a much larger apparent increase was explained by several episodes of pseudobacteremia.

Anti-Bacterial Agents↗
PubMed1982

Management of infected cerebellar stimulation systems.

Over a 7-year period (February 1974 through February 1981), 318 patients underwent the implantation of cerebellar stimulation systems for the reduction of spasticity (98%) or epilepsy (2%). A total of 518 procedures were carried out to implant and maintain the equipment during this period. Fourteen patients developed infections in the tissue around their implanted systems, which represented 4.4% of the patients or 2.7% of the procedures performed. Staphylococcus aureus was the infectious agent in 7 cases (50%), the clinical features of which occurred usually within 1 month. Staphylococcus epidermidis infected 5 patients with features presenting late (more than 2 years) after the initial implantation. The management involved antibiotic therapy for 2 weeks in all 14 patients. In 12 patients, the entire system was removed, with 100% eradication of the infection. In the other 2 patients, the radio receiver and lead wires up to but not including the cerebellar electrode pads were removed. One of these 2 patients has been free of infection for 4 years. The other had S. aureus cultured from removed electrode pads after 6 weeks. Of the 14 cases, morbidity was severe in only 1 patient. Seven patients underwent reimplantation 6 weeks after the infection.

Ampicillin↗