Clinical Characteristics Associated with Antibiotic Treatment Failure for Tuboovarian Abscesses.

OBJECTIVE: Although parenteral antibiotic treatment is a standard approach for tuboovarian abscesses, a significant proportion of patients fail therapy and require interventional radiology (IR) guided drainage. The objective of this study is to assess if specific clinical factors are associated with antibiotic treatment failure. STUDY DESIGN: Retrospective medical record review of patients hospitalized for tuboovarian abscesses from 2001 through 2012 was performed. Clinical characteristics were compared for patients who underwent successful parenteral antibiotic treatment, failed antibiotic treatment necessitating subsequent IR drainage, initial drainage with concurrent antibiotics, and surgery. RESULTS: One hundred thirteen patients admitted for inpatient treatment were identified. Sixty-one (54%) patients were treated with antibiotics alone. Within this group, 24.6% failed antibiotic treatment and required drainage. Mean white blood cell count (K/µL) (18.7 ± 5.94 versus 13.9 ± 5.12) (p = 0.003), mean maximum diameter of tuboovarian abscess (cm) (6.8 ± 2.9 versus 5.2 ± 2.0) (p = 0.03), and length of stay (days) (9.47 ± 7.43 versus 4.59 ± 2.4) (p = 0.002) were significantly greater for patients who failed antibiotic treatment. CONCLUSIONS: Admission white blood cell count greater than 16 K/µL and abscess size greater than 5.18 cm are associated with antibiotic treatment failure. These factors may provide guidance for initial selection of IR guided drainage.

The "Medical Education Roadshow:" Delivering Faculty Development to Busy Clinician Educators When They Least Expect It.

INTRODUCTION: Designing impactful faculty development for busy clinicians is challenging. Many may not recognize their impact on the learning environment or prioritize their development as educators. Our objective was to evaluate the feasibility and acceptability of a faculty development approach, the "Medical Education Roadshow," which delivered succinct, actionable faculty development at regularly scheduled, departmental clinical business meetings. METHODS: Between October 2018 and October 2019, we conducted six 15-minute "roadshows" for the Obstetrics and Gynecology faculty at one academic medical center. Each roadshow addressed a foundational education topic in an interactive manner with an emphasis on one take-away skill in teaching behavior. We utilized a simple, anonymous evaluation tool to obtain participant feedback and analyzed quantitative data descriptively and qualitative data thematically. RESULTS: A total of 174 of 265 evaluations were returned (65.6% response rate). Participants indicated that the roadshows helped them think about teaching more effectively and offered one or more practical daily practice tips. Qualitative findings coalesced into two themes. First, participants identified multiple intended practice changes, including using more effective teaching strategies, being more deliberate about feedback, and modeling exemplary professional behavior. Second, participants recommended multiple improvement opportunities and future topics. DISCUSSION: Busy clinical faculty were highly receptive to opportunities to improve as educators through the "roadshow" approach.

Management strategies for painful bladder syndrome.

Painful bladder syndrome/interstitial cystitis (PBS/IC) is a condition of chronic pelvic pain associated with irritative voiding symptoms. Management of PBS/IC has been a challenge for generations of physicians, owing to a lack of consensus on its definition, an incompletely understood pathophysiology, and numerous available therapies without high-quality evidence to guide their usage. This article reviews the most current conception of PBS/IC and data on effective treatments to recommend a management strategy.