全文获取类型
收费全文 | 104篇 |
免费 | 9篇 |
专业分类
儿科学 | 7篇 |
妇产科学 | 9篇 |
基础医学 | 8篇 |
口腔科学 | 1篇 |
临床医学 | 3篇 |
内科学 | 27篇 |
皮肤病学 | 1篇 |
神经病学 | 3篇 |
外科学 | 10篇 |
综合类 | 2篇 |
预防医学 | 7篇 |
药学 | 8篇 |
肿瘤学 | 27篇 |
出版年
2023年 | 4篇 |
2022年 | 8篇 |
2021年 | 9篇 |
2020年 | 2篇 |
2019年 | 6篇 |
2018年 | 7篇 |
2017年 | 6篇 |
2016年 | 5篇 |
2015年 | 7篇 |
2014年 | 3篇 |
2013年 | 6篇 |
2012年 | 10篇 |
2011年 | 6篇 |
2010年 | 5篇 |
2009年 | 6篇 |
2008年 | 5篇 |
2007年 | 1篇 |
2006年 | 3篇 |
2005年 | 7篇 |
2004年 | 4篇 |
2003年 | 3篇 |
排序方式: 共有113条查询结果,搜索用时 31 毫秒
11.
Othman Alharbi Linda Rabeneck Lawrence F Paszat Duminda N Wijeysundera Rinku Sutradhar Lingsong Yun Christopher M Vinden Jill Tinmouth 《Journal canadien de gastroenterologie》2010,24(7):419-424
BACKGROUND:
Colonoscopy is being increasingly performed in facilities outside of hospitals. Regulation of these facilities is variable, and concerns regarding the quality of procedures in nonhospital (NH) settings have been raised. Further study is needed to better understand endoscopic practice in these facilities.OBJECTIVES:
To describe NH-based colonoscopy practice in Ontario from 1993 to 2005, and to identify patient (age, sex, income quintile and comorbidity) and physician (specialty and colonoscopy volume) factors associated with this practice.METHODS:
The present study was a population-based, cross-sectional analysis using health administrative data from Ontario adults who underwent at least one outpatient colonoscopy between 1993 and 2005. A total of 1,240,781 patients underwent 1,917,714 colonoscopies. The main outcome measure was the receipt of colonoscopy in an NH facility.RESULTS:
An increase in NH-based colonoscopy from 10.0% in 1993 to 15.1% in 2005 (P<0.0001) was found. In the multivariate model, younger, healthier men living in higher income areas were significantly more likely to undergo NH-based colonoscopy. Surgeons and other practitioners (eg, nongastroenterologists and noninternists) were significantly more likely to practice in NH settings. Physicians in the highest colonoscopy volume quintile were 25 times more likely to practice in NH settings than those in the lowest volume quintile (P<0.0001).CONCLUSION:
Rates of NH-based colonoscopy are rising in Ontario. High-volume endoscopists and surgeons are most likely to practice in NH settings. Given its increasing use, further study of the practice and the regulation of NH colonoscopy is warranted. 相似文献12.
13.
Rinku Sutradhar Hsien Seow Craig Earle Deborah Dudgeon Clare Atzema Amna Husain Doris Howell Ying Liu Jonathan Sussman Lisa Barbera 《Journal of pain and symptom management》2013,45(4):726-734
ContextUnderstanding the longitudinal transitions of performance status among persons with cancer can assist providers in determining the appropriate time to initiate palliative care support.ObjectivesTo model longitudinal transitions of performance status in cancer outpatients, to determine the probabilities of improvement and deterioration in performance status over time, and to evaluate the factors associated with rates of transitions.MethodsThis population-based, retrospective, cohort study comprised adult outpatients diagnosed with any type of cancer and assessed for performance status throughout their observation period using the Palliative Performance Scale (PPS; scale 0–100; 0 indicates death). At every PPS assessment, patients were assigned to one of four states: stable state (PPS score 70–100), transitional state (PPS score 40–60), end-of-life state (PPS score 10–30), or dead. A Markov multistate model under the presence of interval censoring was used to examine the rate of state-to-state transitions.ResultsThere were 11,374 patients representing nearly 71,000 assessments. Patients with lung cancer in the transitional state had a 27.7% chance of being dead at the end of one month vs. 17.5% in patients with breast cancer. The average time spent in the transitional state was 6.6 weeks for patients diagnosed with gastrointestinal cancer vs. 8.8 weeks for patients with breast cancer. The rate at which one moves from the transitional state to death was higher for patients with lung cancer than those with breast cancer.ConclusionWe estimated the probability and direction of change in performance status in cancer outpatients. Entry into the transitional state may serve as an indicator for referral for palliative care support. Mean end-of-life sojourn times are too short to allow meaningful integration of palliative care. 相似文献
14.
Rinku MEHRA Ramesh RAMAN Margaret L. BAYLESS William I. SIVITZ 《Journal of Diabetes》2009,1(4):273-277
Background: In the present study, we tested the hypothesis that calories consumed at a prior meal (lunch) may impair glycemic control after a subsequent meal (supper) even if the pre‐supper glucose did not differ regardless of the size of the lunch meal. Methods: Nine subjects with Type 1 diabetes using continuous subcutaneous (s.c.) insulin infusion (CSII) therapy were studied on two separate days. Lunch (1200 h) was randomly assigned as 25% or 50% of the usual daily intake on alternate study days. The CSII was stopped at 1000 h on the day of the study and glucose was controlled until supper by adjusting the rate of intravenous (i.v.) insulin based on glucose measurements every 15 min. The CSII was restarted 1 h before supper and i.v. insulin discontinued 15 min before the first bite of supper. An identical supper meal and pre‐supper s.c. bolus of short‐acting insulin were administered on both visits. Results: Pre‐supper glycemia was nearly identical on each of the two study days. However, the post‐supper glucose area under the curve was 27.5% greater on the day of the antecedent large lunch compared with the small lunch (P = 0.0039). Conclusions: For optimal postprandial glucose control, people with Type 1 diabetes may need to consider not only anticipated meal calories, but also prior food intake, a practice not commonly recommended based on currently used insulin dosing algorithms. 相似文献
15.
Shane Hadlock Linda Rabeneck Lawrence F Paszat Rinku Sutradhar Andrew S Wilton Jill Tinmouth 《Journal canadien de gastroenterologie》2013,27(6):341-346
BACKGROUND
Open-access (OA) colonoscopy may increase efficiency and decrease wait times; however, because the patient is seen for the first time at the endoscopy appointment, previous processes, such as information about the procedure, preparation and appropriate triage, may be suboptimal.OBJECTIVE:
To identify factors associated with OA colonoscopy and to determine the relationship between OA colonoscopy and an important quality measure, incomplete colonoscopy.METHODS:
A population-based analysis of all adult outpatients undergoing a first-time colonoscopy between 1997 and 2007 in Ontario was performed. Colonoscopy was considered to be OA if there were no visits in the preceding five years with the physician performing the colonoscopy. Using logistic regression, patient, physician and institution factors associated with OA colonoscopy were identified. Using propensity score matching, the relationship between OA colonoscopy and incomplete colonoscopy in 2006 was examined.RESULTS:
A total of 1,079,259 colonoscopies were performed. Of these, 14% were OA in 1997 compared with 26% in 2007. Patients 50 to 69 years of age, those from higher-income neighbourhoods and those with less comorbidity were more likely to undergo OA colonoscopy. The odds of receiving OA colonoscopy were six times greater in a nonhospital clinic compared with a community hospital. Colonoscopy was more likely to be complete if the procedure was OA (OR 1.3 [95% CI 1.2 to 1.4]; P<0.0001).CONCLUSIONS:
Rates of OA colonoscopy have increased substantially since 1997. Institution type was most strongly associated with OA colonoscopy. Colonoscopy completeness, a recognized quality indicator, does not appear to be compromised by OA colonoscopy. 相似文献16.
Rinku Sutradhar Nnenna Asidianya Faith Lee Natalie Coburn Linda Rabeneck 《Gastric cancer》2018,21(4):588-597
Background
The risk of gastric carcinoma (GC) varies around the world and between females and males. We aimed to compare the risk of GC among immigrants to Ontario, Canada, to the risk of GC in its general population.Methods
This was a retrospective population-based matched cohort study from 1991 to 2014. We identified immigrants who were first eligible for the Ontario Health Insurance Plan at age 40 years or older, and matched 5 controls by year of birth and sex. We calculated crude rates and relative rates of GC stratified by sex. We modeled GC hazard using multivariable Cox proportional hazards regression, where a time-varying coefficient was incorporated to examine changes in the association of immigrant status with GC hazard over time.Results
Among females, 415 GC cases were identified among 209,843 immigrants and 1872 among 1,049,215 controls. Among males, 596 GC cases were identified among 191,792 immigrants and 2998 among 958,960 controls. Comparing immigrants from East Asia and Pacific with the controls, the crude relative rate of GC was 1.54 for females and 1.32 for males. The adjusted hazard ratio (HR) for GC among female immigrants was 1.29 [95% confidence interval (CI) 1.12, 1.48] within 10 years and 1.19 (1.01, 1.40) beyond 10 years; for males, the HR was 1.17 (1.04, 1.31) within 10 years and 1.00 (0.87, 1.15) beyond 10 years.Conclusion
The risk of GC among immigrants is elevated. Although high-risk immigrant populations in Ontario have been identified, further knowledge is required before a program of GC prevention that is targeted to them can be planned.17.
18.
Terminating observation within matched pairs of subjects in a matched cohort analysis: a Monte Carlo simulation study
下载免费PDF全文
![点击此处可从《Statistics in medicine》网站下载免费的PDF全文](/ch/ext_images/free.gif)
Matched cohort analyses are becoming increasingly popular for estimating treatment effects in observational studies. However, in the applied biomedical literature, analysts and authors are inconsistent regarding whether to terminate follow‐up among members of a matched set once one member is no longer under observation. This paper focused on time‐to‐event outcomes and used Monte Carlo simulation methods to determine the optimal approach. We found that the bias of the estimated treatment effect estimate was negligible under both approaches and that the percentage of censoring had no discernible effect on the magnitude of bias. The mean model‐based standard error of the treatment estimate was consistently higher when we terminated observation within matched pairs. Furthermore, the type 1 error rate was consistently lower when we did not terminate follow‐up within matched pairs. In conclusion, when the focus was on time‐to‐event outcomes, we demonstrated that there was no advantage to terminating follow‐up within matched pairs. Continuing follow‐up on each subject until their observation was naturally complete was superior compared with terminating a subject's observation time once its matched pair had ceased to be under observation. Given the frequency with which these analyses are conducted in the applied literature, our results provide important guidance to analysts and applied researchers as to the preferred analytic approach. Copyright © 2015 John Wiley & Sons, Ltd. 相似文献
19.
Amanda Farah Khan Hsien Seow Rinku Sutradhar Stuart Peacock Kelvin Kar-Wing Chan Fred Burge Kim McGrail Adam Raymakers Beverley Lawson Lisa Barbera 《Current oncology (Toronto, Ont.)》2021,28(6):4673
This retrospective cohort study of cancer decedents during 2004–2015 examined end-of-life cancer care quality indicators (QIs) in the provinces of British Columbia (BC), Ontario, and Nova Scotia (NS). These included: emergency department use, in-patient hospitalization, intensive care unit admissions, physician house calls, home care visits, and death experienced in hospital. Ontario saw the greatest 12-year decrease in in-hospital deaths from 52.8% to 41.1%. Hospitalization rates within 30 days of death decreased in Ontario, increased in NS, and remained the same in BC. Ontario’s usage of aggressive end-of-life measures changed very little, while BC increased their utilization rates. Supportive care use increased in both NS and Ontario. Those who were male or living in a lower income/smaller community (in Ontario) were associated with a decreased likelihood of receiving supportive care. Despite the shift in focus to providing hospice and home care services, approximately 50% of oncology patients are still dying in hospital and 11.7% of patients overall are subject to aggressive care measures that may be out of line with their desire for comfort care. Supportive care use is increasing, but providers must ensure that Canadians are connected to palliative services, as its utilization improves a wide variety of outcomes. 相似文献
20.
Marko Simunovic David Urbach Diane Major Rinku Sutradhar Nancy Baxter Teresa To Adalsteinn Brown Dave Davis Mark N. Levine 《Annals of surgical oncology》2010,17(10):2537-2544