Abstract：
:With the recent regulations limiting resident work hours, it has become more important to understand how residents spend their time. The volume and content of the pages they receive provide a valuable source of information that give insight into their workload and help identify inefficiencies in hospital communication. We hypothesized that above a certain workload threshold, paging data would suggest breakdowns in communication and implications for quality of care. All pages sent to six general surgery interns at the University of Michigan over the course of one academic year (7/1/2008-6/30/2009) were retrospectively categorized by sender type, message type, message modifier, and message quality. Census, discharge, and admission information for each intern service were also collected, and intern duties were further analyzed with respect to schedule. "On-call" days were defined as days on which the intern bore responsibility for care of all admitted floor patients. The interns received a total of 9,843 pages during the study period. During on-call shifts, each intern was paged an average of 57 ± 3 times, and those on non-call shifts received an average of 12 ± 3 pages. Floor/intensive care unit (ICU) nurses represented 32% of the page volume received by interns. Interestingly, as patient volume increased, there was a decrease in the number of pages received per patient. By contrast, at higher patient volumes, there was a trend toward an increasing percentage of urgent pages per patient. At high intern workloads, our data suggest no major communication breakdowns but reveal the potential for inferior quality of care.
journal_name
World J Surgjournal_title
World journal of surgeryauthors
Patel SP,Lee JS,Ranney DN,Al-Holou SN,Frost CM,Harris ME,Lewin SA,Liu E,Madenci A,Majkrzak AA,Nelson J,Peterson SF,Serecky KA,Wilkinson DA,Wojcik BM,Englesbe MJ,Lynch RJdoi
10.1007/s00268-010-0740-9subject
Has Abstractpub_date
2010-11-01 00:00:00pages
2524-9issue
11eissn
0364-2313issn
1432-2323journal_volume
34pub_type
杂志文章abstract：BACKGROUND:The role of lymphadenectomy in adrenocortical carcinoma resection is controversial. Therefore, we conducted a population-based study to assess the association between positive lymph nodes (LN) and survival. METHODS:The Surveillance, Epidemiology, and End Results set of cancer registries were utilized. The a...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-020-05801-x
更新日期：2021-01-01 00:00:00
abstract：BACKGROUND:Literature suggests that patient-informing process prior to obtaining surgical informed consent (SIC) does not function well. This study aimed to provide insight into the current practice of SIC in the Netherlands. METHODS:This is a prospective, observational, and multicenter study, conducted in one academi...
journal_title：World journal of surgery
pub_type： 杂志文章,多中心研究
doi：10.1007/s00268-018-4804-6
更新日期：2019-02-01 00:00:00
abstract：BACKGROUND:The pancreatic fistula rate following distal pancreatectomy ranges widely, from 13.3 to 64.0 %. The optimal closure method of the pancreatic remnant remains controversial, especially regarding whether to use a stapler. METHODS:All patients who underwent distal pancreatectomy in five Japanese hospitals from ...
journal_title：World journal of surgery
pub_type： 杂志文章,多中心研究
doi：10.1007/s00268-012-1595-z
更新日期：2012-08-01 00:00:00
abstract：BACKGROUND:Frailty is a customized marker of biological age that helps to gauge an individual's functional physiologic reserve and ability to react to stress and is associated with increased postoperative morbidity and mortality. In order to mitigate frailty preoperatively, the concept of prehabilitation has entered th...
journal_title：World journal of surgery
pub_type： 杂志文章,评审
doi：10.1007/s00268-020-05658-0
更新日期：2020-11-01 00:00:00
abstract：BACKGROUND:The impact of postoperative complications (POCs) on long-term survival outcomes following hepatic resection for colorectal liver metastasis (CRLM) is in controversy. The aim of the present meta-analysis was to systematically evaluate the POC effect on overall survival (OS) and disease-free survival (DFS) in ...
journal_title：World journal of surgery
pub_type： 杂志文章,meta分析,评审
doi：10.1007/s00268-015-3019-3
更新日期：2015-07-01 00:00:00
abstract：BACKGROUND:Organ shortage is the greatest challenge facing the field of organ transplantation today. Use of more organs of marginal quality has been advocated to address the shortage. METHOD:We examined the pattern of donation and organ use in the United States as shown in the Organ Procurement and Transplantation Net...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-012-1748-0
更新日期：2012-12-01 00:00:00
abstract：:There has been a long, unresolved debate regarding the operation of choice for well differentiated carcinoma of the thyroid. We therefore analyzed the feasibility, scope, sample size, and length of follow-up required to determine the optimal operation for papillary thyroid carcinoma. A statistical approach was used to...
journal_title：World journal of surgery
pub_type： 杂志文章,评审
doi：10.1007/s002689900016
更新日期：1996-01-01 00:00:00
abstract：:Endoscopic management of upper gastrointestinal bleeding has been expanded from a purely diagnostic role to a therapeutic role in many patients. In addition to controlling active bleeding, it is an option in a patient who is clinically at a high risk of rebleeding, or in patients who have peptic ulcers with visible ve...
journal_title：World journal of surgery
pub_type： 杂志文章,评审
doi：10.1007/BF02067057
更新日期：1992-11-01 00:00:00
abstract：:Large ventral hernias are a significant surgical challenge. "Loss of domain" (LOD) expresses the relationship between hernia and abdominal volume, and is used to predict operative difficulty and success. This systematic review assessed whether different definitions of LOD are used in the literature. The PubMed databas...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-018-4783-7
更新日期：2019-02-01 00:00:00
abstract：:The release of the neuronal protein S-100B into the circulation has been suggested as an early indication of cellular brain damage. The objective of this prospective pilot study was to determine S-100B serum levels in patients undergoing cross-clamping during carotid endarterectomy (CEA) and to correlate the results w...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-002-6547-6
更新日期：2002-10-01 00:00:00
abstract：:The management of metastatic neuroendocrine tumors incorporates multimodal therapy with surgery, biotherapy, and chemotherapy. Tumor-targeted therapies using radiolabeled octreotide and metaiodobenzylguanidine (mIBG) represent a novel treatment approach. The aim of this study was to evaluate the effectiveness of 131I-...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-004-7603-1
更新日期：2004-11-01 00:00:00
abstract：AIM:We evaluated the effectiveness and safety of a transanal tube placed for the prevention of anastomotic leakage after rectal surgery. METHODS:Between 2007 and 2011, a total of 243 patients underwent anterior resection using the double stapling technique for rectal cancer at our institution. We excluded 67 patients ...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-013-2428-4
更新日期：2014-07-01 00:00:00
abstract：BACKGROUND:Postoperative ileus is a common problem with significant clinical and economic consequences. We hypothesized that Gastrografin may have therapeutic utility by accelerating the recovery of postoperative ileus after colorectal surgery. The aim of this trial was to study the impact of oral Gastrografin administ...
journal_title：World journal of surgery
pub_type： 杂志文章,随机对照试验
doi：10.1007/s00268-015-3260-9
更新日期：2016-01-01 00:00:00
abstract：:Hereditary breast cancers, mainly due to BRCA1 and BRCA2 mutations, account for only 5-10% of this disease. The threshold for genetic testing is a 10% likelihood of detecting a mutation, as determined by validated models such as BOADICEA and Manchester Scoring System. A 90-95% reduction in breast cancer risk can be ac...
journal_title：World journal of surgery
pub_type： 杂志文章,评审
doi：10.1007/s00268-018-04897-6
更新日期：2019-05-01 00:00:00
abstract：:Hepatoblastoma is a rare pediatric malignancy that frequently appears in an advanced unresectable stage. Improved resectability and survival rate have been reported with the help of neoadjuvant chemotherapy. Between January 1987 and June 1995 a series of 20 patients were managed with a diagnosis of hepatoblastoma. The...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s002680020052
更新日期：2001-02-01 00:00:00
abstract：:Surgeons often are faced with the challenge of balancing truth telling and the maintenance of hope in the setting of a poor prognosis. This ethical dilemma is informed by conflicting appeals to principles of autonomy and nonmaleficence, where a patient's right to be told important medical information must be weighed a...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-014-2566-3
更新日期：2014-07-01 00:00:00
abstract：BACKGROUND:Vibrio vulnificus infection can progress rapidly in skin or soft tissue, and it is potentially life-threatening. The purpose of the present study was to explore the predictors of mortality in patients with V. vulnificus infections of skin or soft tissue. METHODS:The medical records of 119 consecutive patien...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-010-0455-y
更新日期：2010-07-01 00:00:00
abstract：BACKGROUND:Across Nepal, anesthesia at a district level is provided mostly by non-doctor anesthesia providers (anesthesia assistants-AAs). Nepal's Government recognized the need to sustain competence with continuous professional development and to upgrade 6-month trained working AAs to professional equivalence with the...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-017-4273-3
更新日期：2017-12-01 00:00:00
abstract：BACKGROUND:Donor variational arteries often require complex reconstruction. METHODS:We analysed the incidence of different variations, types of arterial reconstructions and their impact on post-operative results from 409 patients undergoing liver transplantation at Karolinska Institute between 2007 and 2015. RESULTS:...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-020-05406-4
更新日期：2020-06-01 00:00:00
abstract：BACKGROUND:Typhoid fever incidence and complications, including intestinal perforation, have declined significantly in high-income countries, with mortality rates <1%. However, an estimated 10.9 million cases still occur annually, most in low- and middle-income countries. With the availability of a new typhoid conjugat...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-020-05567-2
更新日期：2020-09-01 00:00:00
abstract：:Experience with the use of nylon fishing line for surgical sutures has been reported from several African countries. A recent publication suggested that fishing line and an injection needle may provide an atraumatic suture that is especially suitable for intracutaneous skin closures. This article provides further empi...
journal_title：World journal of surgery
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1007/s00268-003-7323-y
更新日期：2004-04-01 00:00:00
abstract：BACKGROUND:The long-term course after peptic ulcer perforation is unclear, but because the ulcer population is generally older and has concomitant disease, the long-term prognosis may be expected to be poor. METHODS:In a study based on prospective data collection, all patients with peptic ulcer perforation treated at ...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-007-9370-2
更新日期：2008-03-01 00:00:00
abstract：:Recently, surgical services have been gaining greater attention as an integral part of public health in low-income countries due to the significant volume and burden of surgical conditions, growing evidence of the cost-effectiveness of surgical intervention, and global disparities in surgical care. Nonetheless, there ...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-010-0585-2
更新日期：2010-11-01 00:00:00
abstract：:Mass screening for the purpose of detecting thyroid cancer at its earliest stage may not be recommended at the present time, but screening focused on certain risk groups is advocated. Familial nonmedullary thyroid carcinoma (FNMTC) is a distinct clinical entity with a high incidence of multifocality and association wi...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-004-7676-x
更新日期：2004-11-01 00:00:00
abstract：INTRODUCTION:Percutaneous needle biopsy (PNB) is the standard of care for diagnosis of breast lesions. Rates of excisional biopsy for breast diagnosis in North America have been reported at approximately 35 %, although significant regional variation exists. A target rate of PNB for diagnosis of breast abnormalities is ...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-015-3293-0
更新日期：2016-07-01 00:00:00
abstract：BACKGROUND:Gastroesophageal reflux is the main risk factor for esophageal adenocarcinoma, but there is no strong support for a protective effect of antireflux surgery. We tested the hypothesis that esophageal adenocarcinoma that develops with long latency after antireflux surgery might be due to persistent postoperativ...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-006-0386-9
更新日期：2007-03-01 00:00:00
abstract：:The pathogenesis of pain in chronic pancreatitis remains an enigma. The cause of pain is almost certainly multifactorial and may vary at different stages of the disease process. These factors may include the release of excessive oxygen-derived free radicals, tissue hypoxia and acidosis, inflammatory infiltration with ...
journal_title：World journal of surgery
pub_type： 杂志文章,评审
doi：10.1007/s00268-003-7235-x
更新日期：2003-11-01 00:00:00
abstract：:Pepsinogen C is a proteolytic enzyme involved in the digestion of proteins in the stomach; it is also synthesized by a significant percentage of female breast carcinomas. In addition, it has been demonstrated that pepsinogen C is one of the few proteins induced by androgens in breast carcinoma cells. Here we evaluate ...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/pl00012325
更新日期：1999-05-01 00:00:00
abstract：BACKGROUND:The aim of this study was to assess the efficacy of the Nd:YAG laser for treating stage I squamous cell carcinoma (SCC) of the lip. The retrospective study was performed in a tertiary care referral hospital in northern India. METHODS:In January 2007 the records of patients treated by Nd:YAG laser ablation o...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-007-9363-1
更新日期：2008-04-01 00:00:00
abstract：:Jaundice in patients of advanced carcinoma of the gallbladder requires palliation for the distressing symptoms of pruritus and cholangitis. Intrahepatic segment III duct cholangiojejunostomy is a means for alleviating the obstruction with malignant porta block. The authors reviewed their experience with this procedure...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s002689900319
更新日期：1997-10-01 00:00:00
