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Biomedical subjects

R P Lofgren

Publications and source records attributed to R P Lofgren.

29 records · Page 2Linked to original sources
PubMed1988

Organizational strategies to improve influenza vaccine delivery. A standing order in a general medicine clinic.

Educational programs designed to modify physician compliance with influenza vaccination guidelines have yielded only modest improvement. We examined the impact of a standing order on the influenza vaccination rate in a general medicine clinic (GMC). The standing order gave GMC nurses the responsibility to identify and vaccinate high-risk elderly patients. The vaccine order rate in GMC patients seen during the one-month study period in 1986 (n = 97) was compared with the rate in GMC patients from a similar period in 1984 (n = 77) and with the rate in patients seen in three subspecialty clinics during the 1986 study period (n = 106). Comparison patients were vaccinated only by specific physician order. Following the intervention, 79 (81%) of 1986 GMC study patients had vaccination orders, vs 20 (28%) of the 1984 GMC comparison group and 31 (29%) of the 1986 subspecialty clinic comparison group. A simple organizational change consisting of a standing order profoundly improved compliance with vaccination guidelines.

Academic Medical Centers↗
PubMed1986

Self-poisoning: outcome and complications in the community hospital.

One hundred sixty cases of self-poisoning of patients aged 15 years and older were treated on the wards of the four community hospitals of Lansing, Michigan, in 1981. Most cases (91 percent) were intentional and represented suicide attempts. The complication rate was 13.8 percent and the overdose-related mortality rate 0.6 percent. Aspiration pneumonia was the most common complication, followed by respiratory failure and seizures. No patient with a level of consciousness stage 0 or 1 in the emergency room had a major overdose-related complication with permanent sequelae, and this group represented 80 percent of the cases. One possible guideline for managing the self-poisoner is level of consciousness in the emergency room.

Adolescent↗
PubMed1984

Acute oligoarthritis associated with Clostridium difficile pseudomembranous colitis.

The abrupt onset of a sterile inflammatory oligoarthritis developed in a patient with active Clostridium difficile pseudomembranous colitis. The arthritis affected a hip and a knee. Leukocyte counts of synovial fluid obtained from the patient's left hip and knee were elevated. He was haplotyped as HLA-B27 antigen-positive. The colitis and arthritis promptly abated after treatment with oral vancomycin hydrochloride. Three other cases of arthritis associated with antibiotic-induced colitis were reviewed. It seems as if treatment of the colitis leads to resolution of the arthritis.

Adult↗
PubMed1983

Asymptomatic ventricular ectopy. To treat or not to treat?

Ventricular ectopy that is bothersome to the patient warrants treatment, but the asymptomatic cases present the physician with a dilemma of whether or not treatment is justified. In patients free of organic heart disease, antiarrhythmic therapy does not appear to be necessary. Post myocardial infarction (MI) patients should be considered for beta-blocker therapy regardless of the presence of ventricular ectopy. In the post-MI patient with risk factors for sudden death, treatment of complex dysrhythmia may be warranted, despite the lack of documented benefit.

Adrenergic beta-Antagonists↗
PubMedDate not supplied

Post-call transfer of resident responsibility: its effect on patient care.

OBJECTIVE: To determine whether transferring the care of patients to another senior resident the day after admission to the hospital adversely affects the efficiency and quality of care. DESIGN: Retrospective analysis of a natural experiment. SETTING: The general medical service of the Minneapolis Veterans Affairs Medical Center, a major tertiary teaching hospital of the University of Minnesota internal medicine residency program. PATIENTS/PARTICIPANTS: Subjects were all the patients admitted to the medicine service from 5:00 PM to 6:00 AM over an eight-month period. INTERVENTION: After 5:00 PM, half of the patients were admitted to the hospital by a cross-covering senior resident (CC group of patients), and their care was transferred to a different senior resident the following day. The other patients were initially evaluated by the primary senior resident (PE group of patients). Assignment to the different services was a random, sequential process. MEASUREMENTS AND MAIN RESULTS: The CC group had significantly more laboratory tests performed during their hospital stay than did the PE group of patients (44 vs. 32, p = 0.01), even when adjusted for length of stay. Using multiple linear regression to adjust for other clinical parameters including length of stay, DRG weight, and number of consults, the authors found that being a CC subject was a significant predictor of the number of laboratory tests obtained (p = 0.01). Furthermore, the median length of stay in the CC group (n = 74) was longer than that in the PE group (n = 72) (eight days vs. six days); this was of borderline statistical significance, using a two-sample median test (p = 0.06). CONCLUSION: Patients transferred to a different resident the day after admission had more laboratory tests performed and longer inpatient stays.

Chi-Square Distribution↗