ABSTRACT
OBJECTIVES: Compliance with coronavirus disease 2019 (COVID-19) guidelines, including the use of masks and social distancing and vaccinations, has been poor. Our study examined what factors may identify those who will be more or less compliant, especially in regard to those with identified higher risk. METHODS: A telephone survey of 200 adult patients from two practices, one general internal medicine and the other rheumatology, was performed in May and June 2021. Questions included age, sex, perception of immunocompetence, smoking history, mask and social distancing compliance, COVID-19 symptoms and/or test-proven infection, and immunization status for COVID-19. Those agreeing to participate also underwent chart review for body mass index, physician-assessed immunocompetence, and diabetes mellitus. RESULTS: No clinical factors approached statistical significance for the prediction of compliance or noncompliance. Compliance with mask and social distancing highly correlated with vaccination and avoidance of infection, however. CONCLUSIONS: Attempts to improve compliance cannot be focused on any of the particular groups examined in this study.
Subject(s)
COVID-19 , Physical Distancing , Adult , Appalachian Region , COVID-19/epidemiology , COVID-19/prevention & control , Humans , Patient Compliance , VaccinationABSTRACT
Pneumomediastinum (PM) is an uncommon condition characterized by the presence of air in the mediastinum. It is associated with alveolar rupture that allows air to traverse along the bronchovascular bundle into the mediastinum. A review of the world medical literature identified 50 additional cases of PM and pneumopericardium (PC) associated with diabetic ketoacidosis (DKA). We report the occurrence of PM, PC, as well as epidural pneumatosis occurring simultaneously in a patient with DKA. Epidural pneumatosis in association with this metabolic derangement has not been previously described.
Subject(s)
Diabetic Ketoacidosis/complications , Mediastinal Emphysema/diagnosis , Pneumopericardium/diagnosis , Spinal Cord Diseases/diagnosis , Adult , Diabetic Ketoacidosis/therapy , Humans , Male , Mediastinal Emphysema/complications , Pneumopericardium/complications , Radiography, Thoracic , Spinal Cord Diseases/complications , Tomography, X-Ray ComputedABSTRACT
A patient presented with scrotal cellulitis as a complication of infusing 900 ml saline into his scrotum. He had obtained a kit along with explicit instructions for performing the infusion through the Internet. This practice may be more widespread than expected. An Internet search revealed many references to this procedure, but a MEDLINE search showed virtually no information in the medical literature. Patients who are considering scrotal inflation, as it is called in the lay literature, should be warned of the potential complications of this procedure.
Subject(s)
Cellulitis/etiology , Genital Diseases, Male/etiology , Scrotum , Sexual Behavior , Sodium Chloride/adverse effects , Adult , Cellulitis/diagnosis , Cellulitis/drug therapy , Cephalexin/therapeutic use , Esthetics , Genital Diseases, Male/diagnosis , Genital Diseases, Male/drug therapy , Humans , Instillation, Drug , Internet , Male , Self Administration , Sodium Chloride/administration & dosageABSTRACT
BACKGROUND: Concerns have been raised about the role that hospitalists may have in changing the educational process for medical students and residents, especially with regard to the primary care specialties. METHODS: We implemented rotating hospital and office duties within our five-physician group. RESULTS: Resident and student satisfaction increased, and additional faculty members could be added without expanding office space. Financial benefits then also ensued. CONCLUSION: Rotating hospital with office duties among a small group of internists has resulted in most of the advantages with few of the drawbacks related to the hospitalist approach.