Abstract:
OBJECTIVE:To measure the effect of duty periods no longer than 16 hours on patient care and resident education. PATIENTS AND METHODS:As part of our Educational Innovations Project, we piloted a novel resident schedule for an inpatient service that eliminated shifts longer than 16 hours without increased staffing or decreased patient admissions on 2 gastroenterology services from August 29 to November 27, 2009. Patient care variables were obtained through medical record review. Resident well-being and educational variables were collected by weekly surveys, end of rotation evaluations, and an electronic card-swipe system. RESULTS:Patient care metrics, including 30-day mortality, 30-day readmission rate, and length of stay, were unchanged for the 196 patient care episodes in the 5-week intervention month compared with the 274 episodes in the 8 weeks of control months. However, residents felt less prepared to manage cross-cover of patients (P = .006). There was a nonsignificant trend toward decreased perception of quality of education and balance of personal and professional life during the intervention month. Residents reported working fewer weekly hours overall during the intervention (64.3 vs 68.9 hours; P = .40), but they had significantly more episodes with fewer than 10 hours off between shifts (24 vs 2 episodes; P = .004). CONCLUSION:Inpatient hospital services can be staffed with residents working shifts less than 16 hours without additional residents. However, cross-cover of care, quality of education, and time off between shifts may be adversely affected.
journal_name
Mayo Clin Procjournal_title
Mayo Clinic proceedingsauthors
McCoy CP,Halvorsen AJ,Loftus CG,McDonald FS,Oxentenko ASdoi
10.4065/mcp.2010.0745subject
Has Abstractpub_date
2011-03-01 00:00:00pages
192-6issue
3eissn
0025-6196issn
1942-5546pii
S0025-6196(11)60151-1journal_volume
86pub_type
杂志文章abstract::The sympathetic nervous system plays a key role in regulating arterial blood pressure in humans. This review provides an overview of sympathetic neural control of the circulation and discusses the changes that occur in various disease states, including hypertension, heart failure, and obstructive sleep apnea. It focus...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.1016/S0025-6196(11)60492-8
更新日期:2009-09-01 00:00:00
abstract::In Olmsted County, Minnesota, population-based epidemiologic research studies are possible because of a unique medical records linkage system, the Rochester Epidemiology Project (REP), which has been in place for almost half a century. We present a summary of epidemiologic data describing the incidence of skin disease...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.1016/j.mayocp.2013.08.018
更新日期:2013-12-01 00:00:00
abstract::Seven cases of bacteremia following transrectal needle biopsy of the prostate were reviewed. Symptoms developed within 24 to 72 hours after the procedure and required hospitalization and treatment with parenteral antibiotics. Escherichia coli was the causative agent in five patients and Klebsiella pneumoniae in two. A...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:
更新日期:1980-08-01 00:00:00
abstract:OBJECTIVE:To compare health care usage between suicide decedents and living controls in the year before suicide in a large representative US population. PATIENTS AND METHODS:Cases (n=1221) and controls (n=3663) belonged to an integrated health care system from January 1, 2009, through December 31, 2014. Cases and cont...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/j.mayocp.2019.04.037
更新日期:2019-10-01 00:00:00
abstract::Many misconceptions continue to persist in both the lay and the professional literature regarding the proper approach to the diagnosis and treatment of hypoglycemia. Often, patients with a symptom complex suggestive of hypoglycemia have normal levels of plasma glucose in association with these symptoms. The major diag...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.1016/s0025-6196(12)64790-9
更新日期:1985-12-01 00:00:00
abstract::We measured cardiopulmonary function at rest and during exercise in 15 healthy survivors of neonatal respiratory distress syndrome (RDS) and compared the results with those in 15 normal subjects. The mean birth weight of the RDS group was 1,771 g, and 12 of the 15 patients had required endotracheal intubation. The oxy...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/s0025-6196(12)65222-7
更新日期:1987-08-01 00:00:00
abstract::In a patient with Wolff-Parkinson-White syndrome, protracted, disabling tachycardia occurred because of low left lateral accessory pathway refractoriness and rapid retrograde conduction, most likely by a septal pathway. Conventional medications, including intravenously administered lidocaine and procainamide, were ine...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:
更新日期:1977-09-01 00:00:00
abstract:OBJECTIVES:To characterize public perception of physicians' conflicts of interest (COIs) across medical and surgical specialties. PATIENTS AND METHODS:A cross-sectional 6-arm randomized survey of a nonprobability sample from Amazon's Mechanical Turk occurred on December 11 to 16, 2018. Survey respondents were randomly...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/j.mayocp.2019.07.009
更新日期:2019-12-01 00:00:00
abstract::A careful clinical history and physical examination are the most important components of the preoperative assessment of the cardiac patient who is to undergo a noncardiac surgical procedure. From these factors and the nature of the surgical procedure planned, a reasonable estimate of potential cardiac risk can be form...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.1016/s0025-6196(12)64980-5
更新日期:1989-09-01 00:00:00
abstract::Myocarditis, an inflammatory disease of heart muscle, is an important cause of dilated cardiomyopathy worldwide. Viral infection is also an important cause of myocarditis, and the spectrum of viruses known to cause myocarditis has changed in the past 2 decades. Several new diagnostic methods, such as cardiac magnetic ...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.1016/S0025-6196(11)60670-8
更新日期:2009-11-01 00:00:00
abstract:OBJECTIVE:To examine the use of tests that measure ejection fraction (EF) and the use of coronary angiography among patients with an initial diagnosis of heart failure (HF). PATIENTS AND METHODS:All potential cases of incident HF in Olmsted County, Minnesota, between 1979 and 1999 were identifled. In a random sample o...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,多中心研究
doi:10.4065/81.7.906
更新日期:2006-07-01 00:00:00
abstract::Nasal telangiectasias, a common condition, can be caused by chronic exposure to ultraviolet light, rosacea, topically applied corticosteroids, or rhinoplasty. Use of the argon laser for 15 to 45 minutes in a continuous mode over the entire involved area can produce considerable lightening of the nasal redness and impr...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/s0025-6196(12)62611-1
更新日期:1986-11-01 00:00:00
abstract::Ocular adnexal lymphoproliferative lesions consist of a spectrum of disease entities, including reactive lymphoid hyperplasia, atypical lymphoid hyperplasia, and lymphoma. No clinical or radiologic criteria facilitate a distinction among these lymphoproliferative lesions. The two hyperplastic processes may evolve to l...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.1016/s0025-6196(12)62275-7
更新日期:1993-10-01 00:00:00
abstract:OBJECTIVE:To present the results of a quality-of-life (QOL) assessment performed with the current version of the Lung Cancer Symptom Scale (LCSS) questionnaire in a large single-institutional data set of 650 patients with lung cancer. PATIENTS AND METHODS:The study group included 650 patients with pathologically confi...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.4065/79.8.1024
更新日期:2004-08-01 00:00:00
abstract::A calcium-binding IgG K monoclonal protein in a patient with multiple myeloma and asymptomatic hypercalcemia was recognized, isolated, and characterized. In addition to binding by the whole IgG molecules, calcium was bound by purified Fab fragments and recombined heavy and light chains. In a competitive binding study,...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:
更新日期:1982-09-01 00:00:00
abstract:OBJECTIVE:To compare coronary artery bypass grafting (CABG) with percutaneous transluminal coronary angioplasty (PTCA) in patients with proximal, isolated de novo left anterior descending coronary artery disease and left ventricular ejection fraction of 45%. PATIENTS AND METHODS:In the multicenter Stenting vs Internal...
journal_title:Mayo Clinic proceedings
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.4065/75.11.1116
更新日期:2000-11-01 00:00:00
abstract:OBJECTIVE:To determine whether blood type affects the risk of thromboembolic complications in patients with atrial fibrillation (AF). PATIENTS AND METHODS:The Mayo Clinic electronic medical record was searched (between January 1, 2004, and December 31, 2010) to identify all patients with AF with blood group assessment...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/j.mayocp.2014.11.013
更新日期:2015-02-01 00:00:00
abstract::In a study of 49 consecutive patients for whom a test for platelet antibodies had been ordered, tests were performed for both cell-bound and serum platelet antibodies. In cases of autoimmune thrombocytopenia (ITP), the test result for cell-bound antibody was more likely to be positive than was the test result for seru...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/s0025-6196(12)65623-7
更新日期:1984-12-01 00:00:00
abstract::Thirty-one patients with low back pain resistant to medical and surgical treatment were studied. On admission to the psychiatric service, these patients revealed apparent features of conversion and hysterical personality, as characterized also by the MMPI profile. During hospitalization, however, there was increased a...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:
更新日期:1976-01-01 00:00:00
abstract:DESIGN:A quality-control retrospective review of medical records was conducted for cases of anaphylaxis encountered at Mayo Clinic Rochester during a 3 1/2-year period. PATIENTS:For inclusion in the study, all patients had to manifest general symptoms of mediator release such as generalized pruritus, urticaria, angioe...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/s0025-6196(12)61606-1
更新日期:1994-01-01 00:00:00
abstract::The old paradigm states that the greater the stenosis, the greater the risk of cardiac events. Revascularization procedures are the only effective approach to improving prognosis associated with coronary artery disease. In contrast, on the basis of the new paradigm, the nature of the plaque determines the risk of acut...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:
更新日期:1996-10-01 00:00:00
abstract:OBJECTIVE:To determine how often patients with renal artery stenosis (RAS) managed without revascularization progress to accelerated hypertension and/or renal failure. PATIENTS AND METHODS:We examined the outcomes of 68 patients (mean +/- SEM age, 71.8 +/- 0.9 years) with high-grade (>70%) RAS identified between 1989 ...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.4065/75.5.437
更新日期:2000-05-01 00:00:00
abstract:OBJECTIVE:To investigate the pharmacodynamic properties of inclisiran, a small interfering RNA targeting proprotein convertase subtilisin-kexin type 9 (PCSK9), in individuals with normal renal function and renal impairment (RI). PATIENTS AND METHODS:The analysis included participants with normal renal function and mil...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.mayocp.2019.08.021
更新日期:2020-01-01 00:00:00
abstract::In 51 patients, the cause for pleural effusion remained indeterminate immediately after thoracotomy. Thirty-one (60.8%) had no recurrence of the effusion, and no cause became apparent during a follow-up period of from 1 1/2 to 15 years. Two patients (3.9%) died relatively soon after thoracotomy, but death was not clea...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:
更新日期:1981-03-01 00:00:00
abstract::Nonrelaxing pelvic floor dysfunction is not widely recognized. Unlike in pelvic floor disorders caused by relaxed muscles (eg, pelvic organ prolapse or urinary incontinence, both of which often are identified readily), women affected by nonrelaxing pelvic floor dysfunction may present with a broad range of nonspecific...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.1016/j.mayocp.2011.09.004
更新日期:2012-02-01 00:00:00
abstract::After the completion of the Human Genome Project, there has been an acceleration in methodologies on sequencing nucleic acids (DNA and RNA) at a high precision and with ever-decreasing turnaround time and cost. Collectively, these approaches are termed next-generation sequencing and are already affecting the transform...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.1016/j.mayocp.2017.03.002
更新日期:2017-05-01 00:00:00
abstract:OBJECTIVE:To describe the survival of a large nonobstructive hypertrophic cardiomyopathy (NO-HCM) cohort and to identify risk factors for increased mortality in this population. PATIENTS AND METHODS:Patients were identified from the Mayo Clinic HCM database from January 1, 1975, through November 30, 2006, for this ret...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/j.mayocp.2016.01.002
更新日期:2016-03-01 00:00:00
abstract::A case of inguinal hernia with massive scrotal enlargement is presented. Walking and voiding had become extremely difficult for the patient; only one testicle could be palpated, and the penis could not be delivered from the scrotal mass. Surgical reduction of the massive hernia was accomplished. The right testis with ...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:
更新日期:1982-06-01 00:00:00
abstract::Stereotactic ventralis lateralis thalamotomy can be performed in selected patients with medically intractable parkinsonian tremor and rigidity. New technology, including computed tomography-based stereotaxis and microelectrode recording techniques, provides a data base for precise localization of thalamic lesions tail...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/s0025-6196(12)65215-x
更新日期:1987-08-01 00:00:00
abstract:OBJECTIVE:To determine whether women who had a hypertensive pregnancy disorder (HPD) have elevated uric acid concentrations decades after pregnancy as compared with women who had normotensive pregnancies. PATIENTS AND METHODS:The Genetic Epidemiology Network of Arteriopathy study measured uric acid concentrations in H...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/j.mayocp.2015.05.020
更新日期:2015-09-01 00:00:00