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Evaluating Communication Skills of Geriatrics Fellows: Interrater Agreement of an Objective Structured Clinical Examination 下载免费PDF全文
Marcos Daniel Saraiva MD Maria Luiza de Melo Paulo MD Thiago Junqueira Avelino‐Silva MD Luiz Antonio Gil‐Junior MD Elina Lika Kikuchi MD Luciana Louzada Farias MD Rafael Lyra Rodrigues Alves MD Gisele Sayuri Suzuki MD Fábio Cesar Olivieri MD Valmari Cristina Aranha MSc Leonardo da Costa Lopes MD PhD Maria Cristina Guerra Passarelli MD PhD Julio Cesar Moriguti MD PhD Eduardo Ferrioli MD PhD Chao Lung Wen MD PhD Daniel Apolinário MD PhD Wilson Jacob‐Filho MD PhD 《Journal of the American Geriatrics Society》2016,64(1):206-207
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Laparoscopic rectopexy for recurrent volvulus of J pouch after total proctocolectomy and ileal pouch anal anastomosis 下载免费PDF全文
Suet‐Ying Lee Ka‐Lung Fok Hester Yui‐Shan Cheung Chung‐Ngai Tang 《Surgical Practice》2015,19(3):133-136
Ileal‐pouch anal anastomosis (IPAA) is most commonly performed after total proctocolectomy for ulcerative colitis and familial adenomatous polyposis. Small‐bowel obstruction is one of the complications that can occur years after the operation, but intestinal obstruction due to volvulus of the J pouch is a rare condition. We report a case of recurrent volvulus in a patient who had undergone IPAA after total proctocolectomy for cancer of the rectum and multiple colonic polyps. The patient underwent laparoscopic rectopexy and had no recurrence of volvulus. 相似文献
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DMD PhDAlan A. Lowe Professor Head DDS PhDTakashi Ono Visting clinical assistant professor postdoctoral Fellow BSc MDKathleen A. Ferguson Canadian Lung Association Fellow DDS MSc PhDEung-Kwon Pae Postgraduate student MBC. Frank Ryan Assistant professor andMDJohn A. Fleetham Professor 《American journal of orthodontics and dentofacial orthopedics》1996,110(6):653-664
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A. Parker Ruhl Minxuan Huang Elizabeth Colantuoni Taruja Karmarkar Victor D. Dinglas Ramona O. Hopkins Dale M. Needham With the National Institutes of Health National Heart Lung Blood Institute Acute Respiratory Distress Syndrome Network 《Intensive care medicine》2017,43(7):980-991
Purpose
To evaluate (1) post-discharge healthcare utilization and estimated costs in ARDS survivors, and (2) the association between patient and intensive care-related variables, and 6-month patient status, with subsequent hospitalization and costs.Methods
Longitudinal cohort study enrolling from four ARDSNet trials in 44 US hospitals. Healthcare utilization was collected via structured interviews at 6 and 12 months post-ARDS, and hospital costs estimated via the Medical Expenditure Panel Survey. Adjusted odds ratios for hospitalization and adjusted relative medians for hospital costs were calculated using marginal two-part regression models.Results
Of 859 consenting survivors, 839 (98%) reported healthcare utilization, with 52% female and a mean age of 49 years old. Over 12 months, 339 (40%) patients reported at least one post-discharge hospitalization, with median estimated hospital costs of US$18,756 (interquartile range $7852–46,174; 90th percentile $101,500). Of 16 patient baseline and ICU variables evaluated, only cardiovascular comorbidity and length of stay were associated with hospitalization, and sepsis was associated with hospital costs. At 6-month assessment, better patient-reported physical activity and quality of life status were associated with fewer hospitalizations and lower hospital costs during subsequent follow-up, and worse psychiatric symptoms were associated with increased hospitalizations.Conclusions
This multicenter longitudinal study found that 40% of ARDS survivors reported at least one post-discharge hospitalization during 12-month follow-up. Few patient- or ICU-related variables were associated with hospitalization; however, physical, psychiatric, and quality of life measures at 6-month follow-up were associated with subsequent hospitalization. Interventions to reduce post-ARDS morbidity may be important to improve patient outcomes and reduce healthcare utilization.9.
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支架型人工血管介入治疗主动脉夹层动脉瘤及主动脉穿透溃疡30例报告 总被引:5,自引:2,他引:5
目的探讨支架型人工血管介入治疗主动脉夹层动脉瘤和主动脉穿透溃疡的可行性及疗效。方法2001年6月至2004年3月,行支架型人工血管治疗主动脉夹层动脉瘤及主动脉穿透溃疡30例。男性24例,女性6例。平均年龄(523±119)岁。25例主动脉夹层动脉瘤中,慢性TypeB23例,急性TypeB1例,TypeA1例。主动脉穿透溃疡5例。术后随诊1~32个月。结果30例支架型人工血管均成功植入。5例有近端内漏,1例术中发生升主动脉夹层,2例分别在术后1d、7d发生升主动脉夹层。术后30d内死亡2例。术后30d内死亡率为67%。1例术后20个月因近端内漏接受第2次支架型人工血管植入术。术后随诊1~32个月,无死亡,亦无支架移位、狭窄等并发症。结论支架型人工血管是治疗主动脉夹层动脉瘤和主动脉穿透溃疡的有效方法,中远期效果还有待进一步观察。 相似文献