Abstract:
OBJECTIVE:To determine the effect of adding a trained intensivist on patient care and educational outcomes in a community teaching hospital. MATERIAL AND METHODS:We retrospectively reviewed outcomes for patients admitted to the medical intensive-care unit (MICU) of a 270-bed community teaching hospital between July 1992 and June 1994. Mortality rates and durations of stay were determined for the year before (BD, 1992 through 1993) and the first year after (AD, 1993 through 1994) introduction of a full-time director of critical care. Performance of resident trainees on a standardized critical-care examination was measured for the same periods. RESULTS:Overall, 459 patients in the BD period were compared with 471 patients in the AD period. The mix of cases and severity of illness (acute physiology and chronic health evaluation or APACHE II scores) on admission were similar for the BD and AD periods. MICU mortality decreased from 20.9% during the BD to 14.9% during the AD period (P = 0.02), and in-hospital mortality decreased from 34.0% to 24.6% (P = 0.002). Disease-specific mortalities were lower during the AD period for most categories of illness. Detailed analysis of a subgroup of patients (those with pneumonia) demonstrated no differences in distribution of patients by gender, race, or acuity of illness (APACHE II scores). The mortality rate due to pneumonia decreased from 46% during the BD period to 31% during the AD period. This decrease was consistent across categories of APACHE II scores. From BD to AD periods, mean durations of total hospital stay decreased from 22.6 +/- 1.4 days to 17.7 +/- 1.0 days, and mean MICU stay decreased from 5.0 +/- 0.3 days to 3.9 +/- 0.3 days (P < 0.05). Critical-care in-service examination scores for 22 residents increased from 53.8 +/- 1.7% to 67.5 +/- 2.2% (P < 0.01), and AD scores were significantly higher than BD scores for residents at similar levels of training. CONCLUSION:Addition of a medical intensivist was temporally associated with improved clinical and educational outcomes in our community teaching hospital.
journal_name
Mayo Clin Procjournal_title
Mayo Clinic proceedingsauthors
Manthous CA,Amoateng-Adjepong Y,al-Kharrat T,Jacob B,Alnuaimat HM,Chatila W,Hall JBdoi
10.4065/72.5.391subject
Has Abstractpub_date
1997-05-01 00:00:00pages
391-9issue
5eissn
0025-6196issn
1942-5546pii
S0025-6196(11)64857-Xjournal_volume
72pub_type
杂志文章abstract::Campylobacter-like organisms (provisionally named C. pyloridis) were demonstrated in gastric biopsy specimens by histopathologic analysis and bacterial culture. C. pyloridis organisms were found in 12 of 26 patients (46%) with gastric or duodenal ulcer but in none of 10 healthy volunteers without histologic evidence o...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/s0025-6196(12)61902-8
更新日期:1987-04-01 00:00:00
abstract:OBJECTIVE:To estimate the age- and sex-adjusted incidence of melanoma in adults 61 years or older in Olmsted County, Minnesota, from 1970 through 2009. PATIENTS AND METHODS:Using Rochester Epidemiology Project resources, 397 patients were identified who were 61 years or older and who received a first lifetime diagnosi...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/j.mayocp.2016.06.028
更新日期:2016-11-01 00:00:00
abstract:OBJECTIVE:To investigate the incidence and risk of adverse clinical outcomes in a "real-world" cohort of patients with atrial fibrillation (AF) anticoagulated with vitamin K antagonists (VKAs) from the Murcia AF Project in comparison with the warfarin arm of the randomized clinical trial (RCT) AMADEUS (Evaluating the U...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/j.mayocp.2018.01.028
更新日期:2018-08-01 00:00:00
abstract::To our knowledge, edema of the lower extremities has not previously been reported as a sign of a pancreatic pseudocyst. In this case report, we describe a 66-year-old man in whom such a lesion compressed the inferior vena cava and caused pronounced leg swelling. After drainage of the pseudocyst, the edema did not recu...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/s0025-6196(12)61125-2
更新日期:1992-11-01 00:00:00
abstract:OBJECTIVE:To present a multiyear clinical experience with intravenous bevacizumab for the management of severe gastrointestinal bleeding and/or epistaxis in patients with hereditary hemorrhagic telangiectasia (HHT). PATIENTS AND METHODS:All patients treated with intravenous bevacizumab for severe hereditary hemorrhagi...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/j.mayocp.2017.11.013
更新日期:2018-02-01 00:00:00
abstract:OBJECTIVE:To evaluate the role of cardiac troponin T (cTnT) in predicting death, recurrent ischemic events, and heart failure among community-dwelling persons with first myocardial infarction (MI). PATIENTS AND METHODS:Consecutive Olmsted County, Minnesota, residents with an incident MI between November 6, 2002, and D...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/j.mayocp.2011.11.013
更新日期:2012-03-01 00:00:00
abstract::Tinnitus, a common complaint, reportedly affects more than 37 million Americans. Most often, it is associated with a sensorineural hearing loss in the high-frequency range. Tinnitus, however, is a symptom and not a disease. Complacency about this symptom complex may cause physicians to overlook a severe underlying pat...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.1016/s0025-6196(12)60521-7
更新日期:1991-06-01 00:00:00
abstract::Total respiratory resistance (Rrs) was studied by the forced oscillation technique at a frequency of 3 cps in 76 normal subjects (36 men, 40 women), ages 21 to 64 years. Slopes (equivalent to specific conductance) assuming a linear relationship with zero intercept between 1/Rrs and thoracic gas volume (TGV) were compu...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:
更新日期:1976-09-01 00:00:00
abstract::Clostridioides difficile infection (CDI) is the leading cause of health care-associated infections in the United States. The increasing incidence and recurrence rates of CDI together with its associated morbidity and mortality are great concerns. Newer treatment methods, such as narrow-spectrum antibiotics, monoclonal...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.1016/j.mayocp.2019.08.006
更新日期:2020-04-01 00:00:00
abstract::Dual-chamber pacing improved hemodynamics acutely in a subset of patients with left ventricular (LV) dysfunction but conveyed no long-term symptomatic benefit in most. More recently, LV pacing and biventricular (multisite) pacing have been used to improve systolic contractility by altering the electrical and mechanica...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.1016/S0025-6196(11)63225-4
更新日期:2001-08-01 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 analyze the effect of adjuvant perfusion techniques of the distal aorta on the outcome of traumatic thoracic aortic transections. PATIENTS AND METHODS:From 1973 to 2004, 72 patients (mean age, 39 years) with thoracic aortic transections arrived alive at the emergency department. Nineteen patients arrived ...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.4065/81.5.625
更新日期:2006-05-01 00:00:00
abstract:OBJECTIVE:To report the clinicopathologic findings in patients with Grover's disease. MATERIAL AND METHODS:We reviewed the medical records and biopsy specimens from 72 patients with transient acantholytic dermatosis (Grover's disease) examined at Mayo Clinic Rochester. Hematoxylin-eosin-stained biopsy specimens (from ...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.4065/74.3.229
更新日期:1999-03-01 00:00:00
abstract:OBJECTIVE:To assess long-term secular trends in the utilization of bilateral compared with unilateral orchiectomy in the community. PATIENTS AND METHODS:This population-based descriptive study reviewed medical records of all Olmsted County, Minnesota, men undergoing orchiectomy between 1956 and 2000. RESULTS:Over the...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.4065/76.12.1199
更新日期:2001-12-01 00:00:00
abstract:OBJECTIVE:To evaluate the frequency and pattern of complementary and alternative medicine (CAM) use in patients referred to a fibromyalgia treatment program at a tertiary care center. PATIENTS AND METHODS:Patients referred to the Mayo Fibromyalgia Treatment Program between February 2003 and July 2003 were invited on t...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/S0025-6196(11)62958-3
更新日期:2005-01-01 00:00:00
abstract:OBJECTIVE:To evaluate the long-term prognostic effect of resting heart rate (HR) at index myocardial infarction (MI) and during the first year after MI among 1-year survivors. PATIENTS AND METHODS:The community-based cohort consisted of 1571 patients hospitalized with an incident MI from January 1, 1983, through Decem...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/j.mayocp.2014.07.017
更新日期:2014-12-01 00:00:00
abstract:OBJECTIVE:To identify and assess the impact of postoperative complications in patients with unrecognized or known obstructive sleep apnea syndrome (OSAS) undergoing hip replacement or knee replacement compared with control patients undergoing similar operations. Although OSAS is a risk factor for perioperative morbidit...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.4065/76.9.897
更新日期:2001-09-01 00:00:00
abstract::A retrospective review of Mayo Clinic records through 1983 revealed 84 patients (24 male and 10 female; mean age, 41 years) with the diagnosis of pulmonary alveolar phospholipoproteinosis. The major clinical features were dyspnea, cough, fever, and chest pain. Chest roentgenograms usually showed bilateral symmetric al...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.1016/s0025-6196(12)65477-9
更新日期:1987-06-01 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:OBJECTIVE:To assess whether patients with pancreatic cancer-associated pain living near a pain control center were more likely to undergo neurolytic celiac plexus block (NCPB) than those living at a distance and to determine the rationale of physicians at our institution for referring patients for NCPB. DESIGN:We retr...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.4065/72.9.831
更新日期:1997-09-01 00:00:00
abstract:OBJECTIVE:To determine the incidence and temporal trends of food allergies. PATIENTS AND METHODS:We performed a historical cohort study to describe the epidemiology of food allergies among residents of all ages in Olmsted County, Minnesota, during a 10-year period from January 2, 2002, through December 31, 2011, using...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/j.mayocp.2018.05.031
更新日期:2018-10-01 00:00:00
abstract::We have observed the effects of concussion on nonanesthetized rats and humans. We believe the phenomenon in both to be identical. There are four obvious stages to concussion and the recovery therefrom: fourth stage--visceral (respiratory) and somatic immobility; third stage--return of irregular visceral (respiratory) ...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:
更新日期:1977-08-01 00:00:00
abstract::Currently, computer-assisted imaging can visualize very fast or very slow nonvisible motion events. We can create measurable geometric representations of physiology, including transformation, blood flow velocity, perfusion, pressure, contractility, image features, electricity, metabolism, and a vast number of other co...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.4065/74.4.399
更新日期:1999-04-01 00:00:00
abstract::Nine patients treated with primary signet ring cell carcinoma of the prostate were identified among 29,783 cases of prostate cancer evaluated at Mayo Clinic from January 15, 1970, until January 2, 2009. A PubMed search of the English-language literature published from January 1, 1980, to January 1, 2010, was then perf...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.4065/mcp.2010.0463
更新日期:2010-12-01 00:00:00
abstract:OBJECTIVE:To report the clinical responses and mediator-release profiles of an aspirin-sensitive man with systemic mast cell disease during aspirin desensitization. MATERIAL AND METHODS:We quantified the release of six mediators during aspirin desensitization. RESULTS:Although aspirin was administered cautiously with...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.4065/70.5.481
更新日期:1995-05-01 00:00:00
abstract:BACKGROUND:In essential tremor and Parkinson disease (PD) tremor, administration of onabotulinumtoxinA via a fixed injection approach improves the tremor, but many patients (30%-70%) develop moderate to severe hand weakness, limiting the use of onabotulinumtoxinA in clinical practice. OBJECTIVE:To evaluate the safety ...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.mayocp.2017.06.010
更新日期:2017-09-01 00:00:00
abstract:OBJECTIVE:To analyze the influence of recent changes in Minnesota statutes that generally require prior authorization for use of medical records for research from patients who received medical care after Jan. 1, 1997. MATERIAL AND METHODS:In this Mayo Clinic Institutional Review Board-approved study, we obtained a str...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.4065/74.4.330
更新日期:1999-04-01 00:00:00
abstract::We treated a patient who developed transient multifocal encephalopathy with extrapyramidal symptoms (oromandibular dystonia, oculogyric crisis, and limb dystonia) in temporal proximity to ondansetron administration on emergence from general anesthesia. No other medications known to cause extrapyramidal reactions were ...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.4065/78.9.1150
更新日期:2003-09-01 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::In almost all dialysis patients, bone aluminum content (BAC) is elevated in comparison with levels in normal subjects. Extremely high BAC (200 micrograms or more of aluminum per gram of bone) is significantly associated with classic aluminum-related osteomalacia. We noted three patients with elevated BAC but without h...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/s0025-6196(12)60539-4
更新日期:1985-05-01 00:00:00