Bhuiyan, M Nadir

Purpose While the clinical utility for Point-of-Care Ultrasound (POCUS) is well-established through its use in clinical practice to enhance diagnostic accuracy, expedite care, and improve patient interactions/communication, its impact on patient experience in outpatient consultative settings remains largely underexplored. We sought to evaluate patients’ experience and satisfaction by incorporating POCUS use during outpatient consultations. Methods In this prospective, cross-sectional survey study conducted in a consultative outpatient internal medicine practice, a continuous sample of 100 patients undergoing POCUS during routine medical evaluations participated. We assessed patient perspectives using a survey that was adapted from validated instruments. The following items were evaluated using the anonymized survey: the extent of patient understanding, the integration of POCUS into the consultation, its impact on patient-doctor communication, perceived quality of care, and overall patient experience. Results Most respondents felt better informed about their health (88%), more thoroughly examined (94%), and reported improved confidence in their physician’s assessment (92%) after the POCUS exam. In addition, POCUS was perceived as a natural part of the consultation (95%) and minimally burdensome (93%). Overall, 96% of study respondents agreed that POCUS improved their quality of care, and 98% described their experience as positive or very positive. Open-ended comments emphasized the immediacy of results, enhanced communication, and cost-effectiveness of the POCUS experience. Conclusion Incorporating POCUS in this environment improved patients’ perceptions of their physician, clinic, and overall care. These findings support the broader adoption of POCUS in similar clinical settings and its potential impact on healthcare delivery and patient satisfaction.

Background: Point-of-care ultrasonography (POCUS) is becoming an increasingly relevant tool in hospital medicine, but its effective application in inpatient perioperative medicine remains to be determined. Much of the POCUS literature describes its use by anesthesiologists to evaluate cardiac function, volume status, pulmonary findings, and gastric volume. Objective: To identify, evaluate, and synthesize all available literature investigating the use of point-of-care ultrasound and associated clinical outcomes in inpatient perioperative medical management. Patients and Methods: A systematic review was designed using the PRISMA guidelines with sources of literature including Ovid, PubMed, Scopus, and the Web of Science. Literature search was conducted for published works between 1 January 2002 to 8 February 2024. Results: Three hundred sixty-seven abstracts were identified in our search, and, ultimately, 24 studies were included in this review. Most studies were done by anesthesiology evaluating cardiopulmonary and gastric POCUS. Studies supported using POCUS to expedite cardiac examination, promptly diagnose postoperative pulmonary complications, and optimize surgical timing. Conclusions: POCUS is a versatile tool in the perioperative setting; however, few studies were powered to assess clinical outcomes, and even fewer showed conclusive evidence of improved clinical outcomes. Furthermore, only two studies evaluated the use of POCUS specifically by acute care providers; more extensive studies are needed from their perspective as they take on increasing perioperative responsibilities.

Ramadan is the Islamic holy month when Muslims around the world fast from dawn to sunset. This 30-day pattern of intermittent diurnal fasting can have a significant physiologic impact on the body. Importantly, oral intake is forbidden during this time, and many patients do not wish to take medications. From a clinical perspective, this potentially impacts healthcare delivery and chronic disease states. Despite these important changes, awareness of individual patient practices remains limited among healthcare providers in North America, which may worsen health disparities in Muslim patients. A fundamental understanding of the cultural and physiological implications of fasting during Ramadan can improve cultural competence and patient outcomes. In this paper, we review the physiologic changes during fasting, medical exemptions to fasting, and special considerations for the care of Muslim patients with chronic conditions who may fast during Ramadan.

Point-of-care ultrasound (POCUS) is a valuable clinical tool used at the patient bedside to rapidly assess a wide variety of symptoms and problems which would otherwise take hours or even days. Though it has become the standard of care in Emergency Medicine and is becoming so in hospital internal medicine, less uptake has been appreciated in the outpatient setting despite reported interest from clinicians practicing there. A number of common barriers have been cited to explain this gap in use, which usually include access to equipment, mentorship, and time. In this review we present a proposed framework for clinicians who have an interest in implementing POCUS in their outpatient practice which we hope can mitigate some of these barriers and provide a more streamlined pathway to their desired goals.

Objectives: The purpose of the present study was to assess and describe the severity of symptoms reported by Covid-19 positive patients who vaped (smoked e-cigarettes) when compared to those who did not vape or smoke at the time of the diagnosis of Covid-19. Methods: Patients from this study are from a well-characterized patient cohort collected at Mayo Clinic between March 1, 2020 and February 28, 2021; with confirmed COVID-19 diagnosis defined as a positive result on reverse-transcriptase–polymerase-chain-reaction (RT-PCR) assays from nasopharyngeal swab specimens. Among the 1734 eligible patients, 289 patients reported current vaping. The cohort of vapers (N = 289) was age and gender matched to 1445 covid-19 positive patients who did not vape. The data analyzed included: date of birth, gender, ethnicity, race, marital status, as well as lifestyle history such as vaping and smoking and reported covid-19 symptoms experienced. Results: A logistic regression analysis was performed separately for each symptom using generalized estimating equations (GEE) with robust variance estimates in order to account for the 1:5 age, sex, and race matched set study design. Patients who vaped and developed Covid-19 infection were more likely to have chest pain or tightness (16% vs 10%, vapers vs non vapers, P = .005), chills (25% vs 19%, vapers vs non vapers, P = .0016), myalgia (39% vs 32%, vapers vs non vapers, P = .004), headaches (49% vs 41% vapers vs non vapers, P = .026), anosmia/dysgeusia (37% vs 30%, vapers vs non vapers, P = .009), nausea/vomiting/abdominal pain (16% vs 10%, vapers vs non vapers, P = .003), diarrhea (16% vs 10%, vapers vs non vapers, P = .004), and non-severe light-headedness (16% vs 9%, vapers vs non vapers, P < .001). Conclusion: Vapers experience higher frequency of covid-19 related symptoms when compared with age and gender matched non-vapers. Further work should examine the impact vaping has on post-covid symptom experience.

Objective Increasing adoption of social media have revolutionized communications between individuals, groups, and organizations This research study was designed to assess the knowledge, skills, and attitudes of internal medicine physicians’ awareness and engagement with social media (sometimes referred to as #SoMe) within the digital landscape of healthcare delivery. Methods An audience-response survey focused on social media “ Social media in Healthcare: Physician Survey,” was administered during the “A Systematic Approach to Medically Unexplained Symptoms” continuing medical education conference. The Conference took place between August 22, 2019 and August 24, 2019. Data was collected on August 23, 2019. A range of 103 (59.5%) to 112 (64.7%) of the total 173 attendees participated in this cross-sectional audience-response survey, depending on the questions answered. Results Most responders were between the ages of 35 and 65 years (79.6%) and female (60.2%). A majority of responders were aware of social media terminology (88.7%), and many had used it personally (46.7%), but only 12% knew how to use social media to search medical topics, 18% used it to network professionally and most (68.9%) had a distrust of social media when it came to the protection of their privacy or their patients’ privacy. Overall, about 29.6% indicated an interest in future continued medical education focused on social media (and 27.4% were neutral). Conclusions Approximately half of the responders used social media but far less engaged its platforms for professional use likely due to privacy related concerns. Distance from academic institutions, where professional social media use is more common likely, played a role in aversion. Awareness of social media’s role in healthcare has increased among physicians in practice, however their participation and knowledge of opportunities remains limited.

The 2019 COVID-19 pandemic has thrown the global health-care system into a chaotic flux. Consolidating and reviewing all available knowledge will be crucial to combating the spread of this novel coronavirus. Prevention is paramount, but health care workers are at increased risk, and protective supplies are being limited and being rationed. Common symptoms include fever, cough, and shortness of breath. Hospitalizations are estimated to occur in about 20% of cases and are mostly due to pneumonia.[1] While multiple promising treatments are being reported in the medical literature; there is limited, reliable clinical data are available. To minimize exposure of medical staff to contagious patients and to provide rapid escalation of care to these patients, a telehealth strategy could be leveraged. Such a strategy would entail the use of both telemedicine visits for communication and digital health platforms for monitoring.