Primary percutaneous closure of a traumatic ventricular septal defect after stab wound to the chest: a case report.

Background: Traumatic ventricular septal defects (VSDs) are life-threatening complications of blunt or stab chest trauma. The standard of care is surgical closure or secondary percutaneous closure due to high surgical risk because of recent sternotomy. Case summary: We present a 22-year-old male with an ice pick-related VSD. It was successfully closed by primary percutaneous approach. After 6 months, the echo Doppler shows no residual shunt, normal pulmonary artery pressure, and normal biventricular function. Discussion: To our knowledge, this is one of the first primary percutaneous closures for knife-related VSD. Early diagnosis and treatment can prevent heart failure and long-term complications. Less necrotic tissue surrounding the VSD compared with post-infarction (PI) VSD allows for early and secure treatment. Percutaneous closure is a feasible and effective choice even in patients who had no prior sternotomy or who reject surgery as a primary treatment strategy.

Establishing an investigational drugs and research residency at an academic medical center.

PURPOSE: The development, structure, and implementation of an innovative residency program designed to help meet a growing need for pharmacists with specialized expertise in investigational drug use and clinical research are described. SUMMARY: Clinical research has become an increasingly complex field, but prior to 2017 there were no U.S. specialty residency training programs focused on pharmacists' role in drug development and the care of patients enrolled in clinical trials. In 2016 Johns Hopkins Hospital (JHH) launched an initiative to develop residency training standards specific to the areas of investigational drug use and clinical research. The residency development process consisted of creation of a residency development committee; a needs assessment, including formation of a diverse panel of internal and external experts to guide identification of key competency areas and development of residency goals and objectives; design of the program's structure, including a framework for required and elective rotations; submission of an application for pre-candidate status to the ASHP Commission on Credentialing; and recruitment efforts. CONCLUSION: The JHH investigational drugs and research residency, a combined PGY1 and PGY2 program with 5 competency areas, 14 goals, and 49 objectives, was granted pre-candidate status by ASHP in November 2016. The first resident began the program in June 2017.

Streamlining the process for initial review of pharmacy residency applications: an analytic approach.

PURPOSE: An analytics-driven process for improving the efficiency of initial candidate screening by pharmacy residency programs is described. METHODS: In an initiative to streamline pharmacy resident selection at Johns Hopkins Hospital, retrospective analyses of materials submitted by prospective residents during two application periods (n = 277) were conducted to identify the applicant characteristics most strongly associated with the ultimate extension of an invitation to interview. Multiple two-member teams of pharmacist reviewers independently scored each application on 13 variables, with the resultant item scores tallied to derive rank sum scores. Univariate and multivariate logistic regression analyses were performed to identify the factors most important in distinguishing candidates invited for an interview from those not invited. RESULTS: Univariate analysis indicated that all 13 evaluated applicant characteristics correlated with the likelihood of an interview invitation, but some were relatively less determinative; these factors were excluded from a final multivariate logistic regression model containing only the 7 factors most strongly predictive of an invitation to interview: grade point average, pharmacy work experience, professional association involvement, rotation experiences, presentations, publications, and skills and certifications. The final model was found to be highly explanatory (r(2) = 0.66) of variances in interview-invitation decisions and has been adopted as a guide to future initial screening of candidate applications. CONCLUSION: By analyzing the relative importance of specific residency applicant characteristics and focusing on those deemed most useful in determining which candidates are invited for interviews, a large teaching institution streamlined preliminary application screening while maintaining an equitable candidate selection process.