Patient-initiated second opinions during acute hospital care

Second opinions are used in medicine in order to make better-informed decisions. Only a few studies have examined patient-initiated second opinions, and even fewer have examined it in the context of acute hospitalization. It is not clear whether patients and families are aware of this right and how often they exercise it during acute hospitalization. The objective of this paper is to identify factors associated with the awareness and utilization of patient-initiated second opinions. A survey was conducted among 92 neurosurgical patients who completed a questionnaire that included information regarding: awareness of second opinion consultations, reasons for not seeking a second opinion, satisfaction from the second opinion and sharing the results of the second opinion with the first physician. Multivariate Logistic Regression analysis was performed to identify potential confounders associated with awareness and seeking a second opinion. Findings revealed that 79% percent of the participants were aware of their right to receive a second opinion; however, only 31% opted to receive a second opinion before/during the hospitalization. Fifty-eight percent received a second opinion related to previous medical conditions. Fifty-four percent did not inform the first physician about the results. The Logistic Regression showed that health insurance, education, religiosity and gender predicted awareness and utilization of second opinions. Current findings indicate that although patients are aware of their right to a second opinion and many have used it in the past, they rarely use it during acute hospitalization. Encouraging health professionals in hospitals to refer their patients to a second opinion as part of shared decision-making, may improve the liability and efficacy of patients\u27 care. Experience Framework This article is associated with the Quality & Clinical Excellence lens of The Beryl Institute Experience Framework. (http://bit.ly/ExperienceFramework) Access other PXJ articles related to this lens. Access other resources related to this lens

Target-Specific Ligands and Gadolinium-Based Complexes for Imaging of Dopamine Receptors: Synthesis, Binding Affinity, and Relaxivity

Magnetic resonance imaging (MRI) and positron emission tomography (PET) are two extremely important imaging modalities with unlimited tissue penetration. Molecular imaging is a field by which specific targets or biological processes are imaged. MRI, which is used for functional imaging and for the diagnosis of a broad range of pathologic conditions, suffers from limited specificity and intrinsically low sensitivity. One possibility to alleviate partially these limitations is to use contrast agents (CAs) and more importantly target-specific CAs. We have developed a modular synthesis of novel ligands and gadolinium­(III)-based target-specific MRI CAs with high relaxivity and high binding affinity toward the dopamine receptors. The prepared ligands and MRI CAs are based on spiperone as targeting moiety. The prepared target-specific CAs can potentially be used for <i>in vitro</i> and possibly <i>in vivo</i> MR imaging of dopaminergic receptors. Importantly the ligands prepared using the modular approach presented in this paper may also be useful for other imaging modalities such as PET (or SPECT) by just replacing, at the last stage of the synthesis, the gadolinium cation by other metal cations having relatively long half-lives, such as ⁶⁴Cu, ⁸⁹Zr, ¹¹In, and more