共查询到20条相似文献,搜索用时 15 毫秒
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Salonia A 《European urology》2008,54(3):501-504
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Sulser T 《European urology》2007,52(6):1549-1553
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Labs JD 《Hand (New York, N.Y.)》2008,3(3):197-202
Emergency Medical Treatment and Active Labor Act, an unfunded mandate for emergency hospital physician coverage, combined with falling reimbursement and escalating medico-legal risk, has resulted in declining enthusiasm for specialty coverage to emergency rooms. In a South West Florida community of 150,000, limited hand surgeons necessitated modification of acute on-call duties for hand trauma, whereby the hospital emergency room personnel performed evaluation and wound management with telephonic consultation followed by referral and definitive care in the outpatient setting by the hand surgeon. The policy for hand care, triage, management, and transfer is reviewed, as well as the first year experience with this highly efficient management methodology for urgent and emergent hand problems. In establishing a county-wide standard of care, emergency rooms and hand surgeons are coordinated to deliver excellent care by treatment protocol. 相似文献
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Paul Kurlansky 《World journal of surgery》2010,34(4):646-651
As a profession, surgery is well into its fourth decade of experience with bilateral internal thoracic artery (BITA) grafting
for the treatment of ischemic cardiovascular disease. Numerous compelling retrospective analyses appear to have documented
a clear benefit for BITA grafting over the use of a single internal thoracic artery (SITA) graft in reducing the long-term
risk of mortality, cardiac mortality, and cardiac events. Despite this wealth of literature and scientific as well as clinical
investigation, the chilling fact remains that the STS database reports that less than 4% of coronary bypass (CABG) operations
involve the use of BITA grafting. The historic, physiologic, and clinical aspects of BITA grafting are reviewed. Clinical
challenges and technical advances are addressed. The future of BITA grafting is explored, both from a research perspective
and from a clinical point of view. 相似文献
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John R. Montgomery Alexandra Highet Mark J. Hobeika Michael J. Englesbe Lisa M. McElroy 《Clinical transplantation》2020,34(2):e13780
Donation after circulatory death (DCD) liver transplantation (LT) has increased slowly over the past decade. Given that transplant surgeons generally determine liver offer acceptance, understanding surgeon incentives and disincentives is paramount. The purpose of this study was to assess aggregate travel distance per successful DCD versus deceased after brain death (DBD) liver procurement as a surrogate for surgeon time expenditure and opportunity cost. All consecutive liver offers made to Michigan Medicine from 2006 to 2017 were analyzed. Primary outcome was the summative travel distance (spent on all attempted procurements) per successful liver procurement that resulted in LT. Donation after circulatory death liver offer acceptance was lower than DBD liver offers, as was proportion of successful procurements among accepted offers. Overall, 10 275 miles were travelled for accepted DCD liver offers, resulting in 23 successful procurements (mean 447 miles per successful DCD liver procurement). For accepted DBD liver offers, 197 299 miles were travelled, resulting in 863 successful procurements (mean 229 miles per successful DBD liver procurement). On average, each successful DCD liver procurement required 218 more miles of travel than each successful DBD liver procurement. Current reimbursement policies poorly reflect increased surgeon travel (and time) expenditures between DCD and DBD liver offers. 相似文献
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